Patient preferences for preventive health checks in Danish general practice: a discrete choice experiment among patients at high risk of noncommunicable diseases

Lars Bruun Larsen, Trine Thilsing, Line Bjørnskov Pedersen, Lars Bruun Larsen, Trine Thilsing, Line Bjørnskov Pedersen

Abstract

Background: Preventive health checks targeted at the at-risk population can be a way of preventing noncommunicable diseases. However, evidence on patient preferences for preventive health checks is limited, especially among patients with a high risk of noncommunicable diseases.

Objective: To examine patient preferences for preventive health checks in Danish general practice, targeting persons at high risk of a noncommunicable disease.

Methods: The method used in this study was a discrete choice experiment (DCE) with five attributes: assess, advice, agree, assist and arrange. The attributes were inspired by the 5A model for behaviour change counselling but was altered for the purpose of this study to grasp the entirety of the general practice-based intervention. Moreover, the attribute levels were defined to resemble daily clinical practice. The experimental design of the DCE was an efficient Bayesian main effects design and the results were analysed using a random utility theory framework.

Results: A total of 148 patients completed the DCE. Patients at high risk of a noncommunicable disease have positive preferences for: giving brief explanations about own lifestyle, practicing shared decision-making with the general practitioner (GP), follow-up counselling with the GP after the preventive health check and scheduling a new appointment right after the preventive health check.

Conclusions: The results provide Danish GPs with evidence on their patients' preferences towards preventive health checks which will enable the GPs to tailor these consultations. Moreover, the results suggest that pre-appointment measures, such as a health profile, may mediate a preference for more action-oriented attributes.

Trial registration: Registered at Clinical Trial Gov (Unique Protocol ID: TOFpilot2016, https://ichgcp.net/clinical-trials-registry/NCT02797392?term=TOFpilot2016&rank=1). Prospectively registered on the 29th of April 2016.

Keywords: Chronic disease; doctor–patient relationship; lifestyle modification/health behaviour change; prevention; primary care; risk assessment.

© The Author(s) 2020. Published by Oxford University Press.

Figures

Figure 1.
Figure 1.
Standardized relative importance scores of attribute levels of the DCE (2016).

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