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. 2023 Apr 1;164(4):675-689.
doi: 10.1097/j.pain.0000000000002775. Epub 2022 Sep 23.

Patient preferences in the treatment of chronic musculoskeletal pain: a systematic review of discrete choice experiments

Mengting Zhu  1 , Dong Dong, Hermione Hin-Man Lo, Samuel Yeung-Shan Wong, Phoenix Kit-Han Mo, Regina Wing-Shan Sit
Affiliations

Patient preferences in the treatment of chronic musculoskeletal pain: a systematic review of discrete choice experiments

Mengting Zhu et al. Pain. .

Abstract

Chronic musculoskeletal pain (CMP) is a preference-sensitive condition for which numerous treatment options are available, each with benefits and risks. Thus, patient preferences play a critical role in decision making. This study summarized evidence from discrete choice experiments (DCEs) to quantify patient preferences for CMP treatment and identified important treatment attributes. A systematic review of DCEs on patient preferences for CMP treatment was conducted. Studies were included if they used DCE to determine patient preferences for CMP. A previously described methodological assessment tool was used to assess the risk of bias. The treatment attributes were summarized and sorted according to the frequency of citation and relative weight. Subgroup analyses were conducted to explore the intervention-specific attributes. A total of 15 eligible studies with 4065 participants were included. We identified "capacity to realize daily life activities," "risk of adverse events," "effectiveness in pain reduction," and "out-of-pocket cost" as important attributes. Although "treatment frequency" and "onset of treatment efficacy" were less frequently mentioned, they were also important attributes. The attribute of "risk of adverse events" was especially important for drug treatment. The "out-of-pocket cost" and "treatment location and mode" were important attributes of exercise therapy. The attributes identified in this review will inform the design of future DCE studies, facilitate the translation of measurement-based care to value-based care, and provide the rationale to promote shared decision making and patient-centered care.

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Conflict of interest statement

The authors have no conflicts of interest (COI) to declare. The authors have checked all authors' COIs and that the COI statement in the text of the manuscript is in agreement with the COI statement on the International Committee of Medical Journal Editors (ICJME) forms.

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Figures

Figure 1.
Figure 1.
Flowchart of studies selected according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses). AMED, Allied and Complementary Medicine Database; DCE, discrete choice experiment.
Figure 2.
Figure 2.
The frequency of attributes that ranked as the top 3 most important.
See this image and copyright information in PMC

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