Patient Preference and Adherence (Jul 2023)
Preferences for Rehabilitation in Persons with a History of Stroke: A Discrete Choice Experiment
Abstract
Shinichi Noto,1 Tatsunori Murata,2 Shota Saito,2 Takahiro Watanabe,3 Makoto Kobayashi2 1Department of Rehabilitation, Niigata University of Health and Welfare, Niigata, Japan; 2CRECON Medical Assessment Inc, Tokyo, Japan; 3Rehabilitation Center, Niigata University Medical and Dental General Hospital, Niigata, JapanCorrespondence: Shinichi Noto, Department of Rehabilitation, Niigata University of Health and Welfare, 1398 Shimami, Kita-ku, Niigata, Japan, Email [email protected]: To investigate the preferences of persons with a history of stroke for various attributes of rehabilitation using a discrete choice experiment (DCE).Design: Cross-sectional study.Setting: A web-based survey.Participants: A total of 600 adults with a history of stroke who were not asked whether or not they had participated in previous rehabilitation.Intervention: None.Main Outcome Measures: Preference weights by attribute ie, treatment time (30 minutes, one hour, one and a half hours), treatment content (walking exercises, activities of daily living; ADL exercises), priority treatment of paralyzed limbs (upper extremity, lower upper extremity), treatment location (hospital visit, home visit), therapist gender, and out-of-pocket costs for stroke rehabilitation using discrete choice experiment.Results: The most common self-reported diagnosis was cerebral infarction (408 patients, 68%). The mean age was 62.0 ± 9.8 years, and 515 (85.8%) were male. Of the five attributes, excluding out-of-pocket costs, the highest relative importance score was treatment location (0.331), followed by treatment time (0.304). Among the rehabilitation programs, the statistically significant coefficients calculated were one hour of therapy (0.173, 95% CI = 0.088– 0.258), hospital visits (0.241, 95% CI = 0.180– 0.303), and female therapists (0.186, 95% CI = 0.125– 0. 247). No significant differences were obtained regarding the treatment contents or the paralyzed limb to be treated.Conclusion: A discrete choice experiment revealed that persons with a history of stroke prefer a one-hour hospital rehabilitation program with a female therapist, with cost being a major consideration for rehabilitation. The results of this study may provide useful information for rehabilitation professionals.Keywords: stroke, rehabilitation, preference, physical therapy, occupational therapy
