Article type
Year
Abstract
Background: The optimal method of managing chronic health problems has been a longstanding problem for health services around the world. One method proposed to improve management of chronic conditions is the implementation of interventions to support self care. These range from simple interventions, such as provision of a guidebook describing symptom management, to complex interventions such as group therapies with goal setting.
A previous systematic review of economic evaluations of these interventions identified 39 studies. Many of these evaluations, and much of the clinical literature, focuses on outcome measures rarely used in evaluations of other interventions. These psychological outcomes are considered important by advocates of interventions to support self care. However, their use raises important methodological questions for economic evaluation and systematic reviews as well as having pronounced relevance for the use of systematic reviews in the development of policy.
Objectives: The objectives of this study are to address the following:
1. Are these psychological outcomes valued by consumers?
2. How can decision-makers judge whether improvements in these measures are worth paying for? For instance, if a systematic review shows that interventions are associated with an increase in confidence, should this influence policy decisions?
3. How can these measures be included in a systematic review and/or economic evaluation?
Methods: One method to determine whether consumers value psychological outcomes (such as confidence) is to conduct a discrete choice experiment (DCE).
DCEs are used to explore the attributes (or characteristics) of an intervention that are valued by patients. In this instance the DCE, conducted on a convenient sample of 600 chronically ill consumers, was used to assess the relative values given to psychological factors compared with more commonly used measures of health outcome.
Results: The results of the DCE will be presented. The degree to which consumers trade-off between psychological outcomes and other health outcomes will be considered.
Discussion: Discussion will centre on the importance of these measures, whether they should be incorporated into economic evaluations and systematic reviews. The policy relevance of these findings will be discussed in the context of the increased provision of self care support interventions.
A previous systematic review of economic evaluations of these interventions identified 39 studies. Many of these evaluations, and much of the clinical literature, focuses on outcome measures rarely used in evaluations of other interventions. These psychological outcomes are considered important by advocates of interventions to support self care. However, their use raises important methodological questions for economic evaluation and systematic reviews as well as having pronounced relevance for the use of systematic reviews in the development of policy.
Objectives: The objectives of this study are to address the following:
1. Are these psychological outcomes valued by consumers?
2. How can decision-makers judge whether improvements in these measures are worth paying for? For instance, if a systematic review shows that interventions are associated with an increase in confidence, should this influence policy decisions?
3. How can these measures be included in a systematic review and/or economic evaluation?
Methods: One method to determine whether consumers value psychological outcomes (such as confidence) is to conduct a discrete choice experiment (DCE).
DCEs are used to explore the attributes (or characteristics) of an intervention that are valued by patients. In this instance the DCE, conducted on a convenient sample of 600 chronically ill consumers, was used to assess the relative values given to psychological factors compared with more commonly used measures of health outcome.
Results: The results of the DCE will be presented. The degree to which consumers trade-off between psychological outcomes and other health outcomes will be considered.
Discussion: Discussion will centre on the importance of these measures, whether they should be incorporated into economic evaluations and systematic reviews. The policy relevance of these findings will be discussed in the context of the increased provision of self care support interventions.