Patient preferences for using remote care technology in heart failure: A discrete choice experiment (Preprint)

Remote care technology can bridge the gap between healthcare and community settings, provide more continuous and frequent monitoring of the disease process, and aid in self-care. A common barrier however is the lack of patient engagement with remote care technologies. This discrete choice experiment elicits the preferences of heart failure patients with regard to remote care technologies, and in turn, creates a hierarchy of factors that can affect engagement. A discrete choice experiment survey was designed with input from a patient group. The experimental attributes were based on five central themes (each of which had positive and negative levels): communication, clinical care, education, ease of use, and convenience. The survey allowed participants to trade attributes according to their preferences. The survey was distributed to 93 participants with heart failure. The results were analysed using binary logit to obtain preference weights for each attribute. The binary logit created coefficients for each attribute, all of which were significant (p<0.01), and which equated to the relative preference of the associated themes: clinical care (2.022), education (1.252), convenience (1.245), ease of use (1.155) and communication (1.040). The most preferred factor, clinical care, had enough value to be traded for approximately any two other factors. Communication was the least preferred attribute. Technology designers can use the associated preference weights to determine the relative increase of value perceived by patients by adding in certain attributes, and thus increase engagement from patients most likely to benefit from remote care.