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Novel application of discrete choice experiment methodology to understand how clinicians around the world triage palliative care needs: A research protocol

Published online by Cambridge University Press:  03 January 2019

Bethany Russell Open the ORCID record for Bethany Russell [Opens in a new window] ,
Sara Vogrin ,
Jennifer Philip Open the ORCID record for Jennifer Philip [Opens in a new window] ,
Nicole Hennessy-Anderson ,
Anna Collins ,
Jodie Burchell ,
Brian Le ,
Caroline Brand ,
Peter Hudson  and
Vijaya Sundararajan
Bethany Russell*
Affiliation:
Victorian Comprehensive Cancer Centre, Palliative Medicine Research Group, Department of Medicine, University of Melbourne, Victoria, Australia Centre for Palliative Care, St Vincent's Hospital Melbourne, Victoria, Australia Department of Palliative Care, St Vincent's Hospital Melbourne, Victoria, Australia
Sara Vogrin
Affiliation:
Department of Medicine, St Vincent's Hospital Melbourne and University of Melbourne, Victoria, Australia
Jennifer Philip
Affiliation:
Victorian Comprehensive Cancer Centre, Palliative Medicine Research Group, Department of Medicine, University of Melbourne, Victoria, Australia Department of Palliative Care, St Vincent's Hospital Melbourne, Victoria, Australia Victorian Comprehensive Cancer Centre, Victoria, Australia
Nicole Hennessy-Anderson
Affiliation:
Centre for Palliative Care, St Vincent's Hospital Melbourne, Victoria, Australia
Anna Collins
Affiliation:
Victorian Comprehensive Cancer Centre, Palliative Medicine Research Group, Department of Medicine, University of Melbourne, Victoria, Australia
Jodie Burchell
Affiliation:
Department of Medicine, St Vincent's Hospital Melbourne and University of Melbourne, Victoria, Australia
Brian Le
Affiliation:
Victorian Comprehensive Cancer Centre, Victoria, Australia Department of Palliative Care, Royal Melbourne Hospital, Victoria, Australia
Caroline Brand
Affiliation:
Melbourne Epicentre, University of Melbourne and Melbourne Health, Victoria, Australia Department of Preventive Medicine, Monash University, Victoria, Australia
Peter Hudson
Affiliation:
Centre for Palliative Care, St Vincent's Hospital Melbourne, Victoria, Australia Vrije University, Brussels, Belgium School of Health Sciences, University of Melbourne, Victoria, Australia
Vijaya Sundararajan
Affiliation:
Centre for Palliative Care, St Vincent's Hospital Melbourne, Victoria, Australia Department of Medicine, St Vincent's Hospital Melbourne and University of Melbourne, Victoria, Australia
*
Author for correspondence: Bethany Russell, F.R.A.C.P., F.A.Ch.P.M., M.B.B.S., St Vincent's Hospital Melbourne, PO Box 2900, Fitzroy, Victoria, Australia3065. E-mail beth.russell@svha.org.au
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Abstract

Objective

As referrals to specialist palliative care (PC) grow in volume and diversity, an evidence-based triage method is needed to enable services to manage waiting lists in a transparent, efficient, and equitable manner. Discrete choice experiments (DCEs) have not to date been used among PC clinicians, but may serve as a rigorous and efficient method to explore and inform the complex decision-making involved in PC triage. This article presents the protocol for a novel application of an international DCE as part of a mixed-method research program, ultimately aiming to develop a clinical decision-making tool for PC triage.

Method

Five stages of protocol development were undertaken: (1) identification of attributes of interest; (2) creation and (3) execution of a pilot DCE; and (4) refinement and (5) planned execution of the final DCE.

Result

Six attributes of interest to PC triage were identified and included in a DCE that was piloted with 10 palliative care practitioners. The pilot was found to be feasible, with an acceptable cognitive burden, but refinements were made, including the creation of an additional attribute to allow independent analysis of concepts involved. Strategies for recruitment, data collection, analysis, and modeling were confirmed for the final planned DCE.

Significance of results

This DCE protocol serves as an example of how the sophisticated DCE methodology can be applied to health services research in PC. Discussion of key elements that improved the utility, integrity, and feasibility of the DCE provide valuable insights.

Keywords

Palliative careHospicesTriageResource allocationChoice behaviorPatient-centered care
Type
Original Article
Information
Palliative & Supportive Care , Volume 17 , Issue 1 , February 2019 , pp. 66 - 73
Copyright
Copyright © Cambridge University Press 2019 

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