How to Implement Adherence-Promoting Programs in Clinical Practice? A Discrete Choice Experiment on Physicians' Preferences

Sabrina Müller; Tjalf Ziemssen; Curt Diehm; Tobias Duncker; Philipp Hoffmanns; Inga-Marion Thate-Waschke; Markus Schürks; Thomas Wilke

doi:10.2147/PPA.S222725

How to Implement Adherence-Promoting Programs in Clinical Practice? A Discrete Choice Experiment on Physicians' Preferences

Patient Prefer Adherence. 2020 Feb 14:14:267-276. doi: 10.2147/PPA.S222725. eCollection 2020.

Authors

Sabrina Müller¹, Tjalf Ziemssen², Curt Diehm³, Tobias Duncker⁴, Philipp Hoffmanns⁵, Inga-Marion Thate-Waschke⁶, Markus Schürks⁶, Thomas Wilke⁷

Affiliations

¹ Ingress-Health, Wismar 23966, Germany.
² Zentrum für klinische Neurowissenschaften, Klinik und Poliklinik für Neurologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden 01307, Germany.
³ Private Practice, Ettlingen 76275, Germany.
⁴ Institut für Augenheilkunde Halle, Halle 06114, Germany.
⁵ Private Practice, Rheinstetten 76287, Germany.
⁶ Bayer Vital GmbH, Leverkusen 51368, Germany.
⁷ Institut für Pharmakoökonomie und Arzneimittelogistik, Wismar 23966, Germany.

Abstract

Introduction: The aim of this study was to examine physicians' preferences regarding adherence-promoting programs (APPs), and to investigate which APP characteristics influence the willingness of physicians to implement these in daily practice.

Materials and methods: A discrete choice experiment was conducted among general practitioners, cardiologists, neurologists and ophthalmologists in Germany. The design considered five attributes with two or three attribute levels each: validation status of the APP; possibility for physicians to receive a certificate; type of intervention; time commitment per patient and quarter of the year to carry out the APP; reimbursement for APP participation, per included patient and quarter of the year.A multinomial logit model was run to estimate physicians' utility for each attribute and to evaluate the influence of different levels on the probability of choosing a specific APP. The relative importance of the attributes was compared between different pre-defined subgroups.

Results: In total, 222 physicians were included in the analysis. The most important characteristics of APPs were time commitment to carry out the program (34.8% importance), reimbursement (33.3%), and validation status of the program (23.7%). The remaining attributes (type of intervention: 3.6%; possibility to receive a certificate: 4.7%) were proven to be less important for a physician's decision to participate in an APP. Physicians on average preferred APP alternatives characterized by little time commitment (β=1.456, p<0.001), high reimbursement for work (β=1.392, p<0.001), "positive validation status" (β=0.990, p<0.001), the "possibility to get a certificate" (β=0.197, p<0.001), and the provision of "tools for both physicians and patients" (β=0.150, p<0.001).

Conclusion: For the majority of the physicians participating in this survey, the willingness to implement an APP is determined by the associated time commitment and reimbursement. Considering physicians' preferences regarding different APP features in the promoting process of these programs may enhance physicians' participation and engagement.

Keywords: adherence interventions; adherence promoting programs; compliance programs; discrete choice experiment.