Preferences of people with diabetes for diabetes care in Germany: a discrete choice experiment

ABSTRACT

Objectives

The objective of this study is to elicit health care preferences of people with diabetes and identify classes of people with different preferences.

Methods

A discrete choice experiment was conducted among people with diabetes in Germany comprising attributes of role division in daily diabetes care planning, type of lifestyle education, support for correct medication intake, consultation frequency, emotional support, and time spent on self-management. A conditional logit model and a latent class model were used to elicit preferences toward diabetes care and analyze preference heterogeneity.

Results

A total of 76 people with diabetes, recruited in two specialized diabetes care centers in Germany (mean age 51.9 years, 37.3% women, 49.1% type 2 diabetes mellitus, 50.9% type 1 diabetes mellitus), completed the discrete choice experiment. The most important attributes were consultation frequency, division in daily diabetes care planning, and correct medication intake. The latent class model detected preference heterogeneity by identifying two latent classes which differ mainly with respect to lifestyle education and medication intake.

Conclusion

While the majority of people with diabetes showed preferences in line with current health care provision in Germany, a relevant subgroup wished to strengthen lifestyle education and medication intake support with an aid or website.

KEYWORDS:

• Diabetes mellitus
• discrete choice experiment
• health care
• latent class analysis
• patient preferences
• preference assessment
• preference elicitation
• self-management

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Authors’ contributions

M Vomhof, AC Boersma, A Icks, and M Hiligsmann made substantial contributions to the conceptualization and design of the study. M Kaltheuner, M Krichbaum, and B Kulzer contributed to the data acquisition. M Vomhof, AC Boersma, DFL Hertroijs, and M Hiligsmann contributed to the analysis and interpretation of data. The paper was drafted by M Vomhof and AC Boersma and revised by DFL Hertroijs, M Kaltheuner, M Krichbaum, B Kulzer, A Icks, and M Hiligsmann. All authors read and gave final approval for the version to be published.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Availability of data and materials

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14737167.2024.2369293

Additional information

Funding

The study was supported by institutional funding (German Diabetes Center) of the Federal Ministry of Health and by the Ministry of Culture and Science of North Rhine-Westphalia. It was further funded by the Federal Ministry of Education and Research as part of the German Center for Diabetes Research. The study sponsor/funder was not involved in the design of the study; the collection, analysis, and interpretation of data; writing the report; and did not impose any restrictions regarding the publication of the report.