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. 2012;7(10):e47470.
doi: 10.1371/journal.pone.0047470. Epub 2012 Oct 17.

Discrete choice experiment to evaluate factors that influence preferences for antibiotic prophylaxis in pediatric oncology

Dean A Regier  1 , Caroline Diorio, Marie-Chantal Ethier, Amanda Alli, Sarah Alexander, Katherine M Boydell, Adam Gassas, Jonathan Taylor, Charis Kellow, Denise Mills, Lillian Sung
Affiliations

Discrete choice experiment to evaluate factors that influence preferences for antibiotic prophylaxis in pediatric oncology

Dean A Regier et al. PLoS One. 2012.

Abstract

Background: Bacterial and fungal infections in pediatric oncology patients cause morbidity and mortality. The clinical utility of antimicrobial prophylaxis in children is uncertain and the personal utility of these agents is disputed. Objectives were to use a discrete choice experiment to: (1) describe the importance of attributes to parents and healthcare providers when deciding between use and non-use of antibacterial and antifungal prophylaxis; and (2) estimate willingness-to-pay for prophylactic strategies.

Methods: Attributes were chances of infection, death and side effects, route of administration and cost of pharmacotherapy. Respondents were randomized to a discrete choice experiment outlining hypothetical treatment options to prevent antibacterial or antifungal infections. Each respondent was presented 16 choice tasks and was asked to choose between two unlabeled treatment options and an opt-out alternative (no prophylaxis).

Results: 102 parents and 60 healthcare providers participated. For the antibacterial discrete choice experiment, frequency of administration was significantly associated with utility for parents but not for healthcare providers. Increasing chances of infection, death, side effects and cost were all significantly associated with decreased utility for parents and healthcare providers in both the antibacterial and antifungal discrete choice experiment. Parental willingness-to-pay was higher than healthcare providers for both strategies.

Conclusion: Chances of infection, death, side effects and costs were all significantly associated with utility. Parents have higher willingness-to-pay for these strategies compared with healthcare providers. This knowledge can help to develop prophylaxis programs.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Flow diagram of parent participants through the study.
Figure 2
Figure 2. Attribute importance ranking for antibacterial prophylaxis.
Abbreviation: HCPs – healthcare providers.
Figure 3
Figure 3. Attribute importance ranking for antifungal prophylaxis.
See this image and copyright information in PMC

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