Centre for Health Economics, University of York, York, UK.
Department of Health Sciences, University of York, York, UK.
Int J Technol Assess Health Care. 2022 Oct 26;38(1):e77. doi: 10.1017/S0266462322003233.
Wearable digital health technologies (DHTs) have the potential to improve chronic kidney disease (CKD) management through patient engagement. This study aimed to investigate and elicit preferences of individuals with CKD toward wearable DHTs designed to support self-management of their condition.
Using the results of our review of the published literature and after conducting qualitative patient interviews, five-choice attributes were identified and included in a discrete-choice experiment. The design consisted of 10-choice tasks, each comprising two hypothetical technologies and one opt-out scenario. We collected data from 113 adult patients with CKD stages 3-5 not on dialysis and analyzed their responses via a latent class model to explore preference heterogeneity.
Two patient segments were identified. In all preference segments, the most important attributes were the device , and of information provided. Patients within the largest preference class (70 percent) favored information provided in any format except the audio, while individuals in the other class preferred information in text format. In terms of the style of engagement with the device, both classes wanted a device that provides options rather than telling them what to do.
Our analysis indicates that user preferences differ between patient subgroups, supporting the case for offering a different design of the device for different patients' strata, thus moving away from a one-size-fits-all service provision. Furthermore, we showed how to leverage the information from user preferences early in the R&D process to inform and support the provision of nuanced person-centered wearable DHTs.
可穿戴数字健康技术(DHT)有可能通过患者参与来改善慢性肾脏病(CKD)的管理。本研究旨在调查和了解 CKD 患者对旨在支持其病情自我管理的可穿戴 DHT 的偏好。
利用我们对已发表文献的综述结果,并在进行定性患者访谈后,确定了五个选择属性,并将其纳入离散选择实验。设计包括 10 个选择任务,每个任务包括两个假设技术和一个退出方案。我们从 113 名未接受透析的 CKD 3-5 期成年患者中收集数据,并通过潜在类别模型分析他们的反应,以探索偏好异质性。
确定了两个患者群体。在所有偏好群体中,最重要的属性是设备、提供的信息类型和信息格式。在最大偏好类别的患者(70%)中,除了音频外,他们更喜欢以任何格式提供的信息,而另一类患者则更喜欢以文本格式提供的信息。就与设备互动的风格而言,两个群体都希望设备提供选项,而不是告诉他们该做什么。
我们的分析表明,患者亚组之间的用户偏好存在差异,这支持为不同患者群体提供不同设计的设备的说法,从而避免一刀切的服务提供。此外,我们展示了如何在研发过程的早期利用用户偏好信息,为提供细致入微的以人为本的可穿戴 DHT 提供信息和支持。