Patients’ and professionals’ preferences in terms of the attributes of home enteral nutrition products in Spain. A discrete choice experiment

• Published in: European journal of clinical nutrition Vol. 72; no. 2; pp. 272 - 280
• Main Authors: Olveira, Gabriel, Ángel Martínez-Olmos, Miguel, de Bobadilla, Belén Fernández, Ferrer, Mercedes, Virgili, Nuria, Vega, Belén, Blanco, Mercedes, Layola, Miquel, Lizán, Luis, Gozalbo, Irmina
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.02.2018; Nature Publishing Group
• Subjects: 692/699/1702/295; 692/700/2814; Adaptation; Aged; Calories; Choice Behavior; Clinical Nutrition; Containers; Enteral nutrition; Enteral Nutrition - adverse effects; Enteral Nutrition - instrumentation; Epidemiology; Female; Geriatrics; Home Care Services; Humans; Internal Medicine; Male; Materials handling; Medicine; Medicine & Public Health; Metabolic Diseases; Middle Aged; Nutrition; Nutrition research; Nutritional Requirements; Nutritional Status; Nutritive Value; Older people; Patient Preference; Patients; Perception; Physicians; Public Health; Spain; Surveys and Questionnaires; Spain
• ISSN: 0954-3007; 1476-5640; 1476-5640
• DOI: 10.1038/s41430-017-0023-8

Background/objectives To elicit and compare preferences in terms of the attributes of home enteral nutrition (HEN) among patients and physicians, using a discrete choice experiment (DCE). Subjects/methods A DCE comprising eight choice scenarios, with six HEN attributes (tolerability, adaptation to comorbidities, nutrition and calories, handling, connections and information; two levels each) was designed. The Relative Importance (RI) for patients and physicians of each attribute was estimated. Sociodemographic and clinical variables, as well as additional questions ( n  = 8) were compiled to analyze possible explanatory variables and other preferences. Results A total of 148 HEN patients (71 needing caregivers to answer on their behalf) and 114 physicians completed the DCE. The most important attributes for patients were adaptation to comorbidities (33% RI), tolerability (33% RI), and nutrition and calories (26% RI). Significantly, younger patients had stronger preferences for tolerability whereas elderly ones (≥75 years) were more concerned about handling . In comparison, physicians gave a higher RI to tolerability , and nutrition and calories compared to patients ( p  = 0.002). Overall, a higher percentage of physicians answered that HEN characteristics such as easy-handling bags (85.1 vs. 64.9%; p  = 0.001), container material (69.3 vs. 57.1%; p  = 0.003) or reusable containers (79.8 vs. 70.3%; p  = 0.01) were “important” or “very important” compared to patients. Conclusions Our findings showed that although patients and physicians have a similar perception about the relevance of different HEN attributes, the relative weight given to each one varies between them. Therefore, both points of view should be considered when choosing a HEN product in order to improve patients’ satisfaction and clinical outcomes.