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oai:recercat.cat:10459.1/4632492025-09-15T18:26:47Zcom_2072_3622col_2072_479130

Women’s preference to apply shared decision-making in breast cancer screening: a discrete choice experiment Hernández Leal, María José Pérez Lacasta , María José Cardona Cardona, Àngels Codern-Bové, Núria Vidal, Carmen Rué i Monné, Montserrat Forné Izquierdo, Carles Carles Lavila, Misericòrdia Breast tumours Health economics Preventive medicine Primary care Objective To analyse women’s stated preferences for establishing the relative importance of each attribute of shared decision-making (SDM) and their willingness to pay (WTP) for more participatory care in breast cancer screening programmes (BCSP). Design A discrete choice experiment was designed with 12 questions (choice tasks). It included three attributes: ‘How the information is obtained’, regarding benefits and harms; whether there is a ‘Dialogue for scheduled mammography’ between the healthcare professional and the woman; and, ‘Who makes the decision’, regarding participation in BCSP. Data were obtained using a survey that included 12 choice tasks, 1 question on WTP and 7 socioeconomic-related questions. The analysis was performed using conditional mixed-effect logit regression and stratification according to WTP. Setting Data collection related to BCSP was conducted between June and November 2021 in Catalonia, Spain. Participants Sixty-five women aged between 50 and 60. Main outcome measures Women’s perceived utility of each attribute, trade-off on these attributes and WTP for SDM in BCSP. Result The only significant attribute was ‘Who makes the decision’. The decision made alone (coefficient=2.879; 95% CI=2.297 to 3.461) and the decision made together with a healthcare professional (2.375; 95% CI=1.573 to 3.177) were the options preferred by women. The former contributes 21% more utility than the latter. Moreover, 52.3% of the women stated a WTP of €10 or more for SDM. Women’s preferences regarding attributes did not influence their WTP. Conclusions The participant women refused a current paternalistic model and preferred either SDM or informed decision-making in BCSP. Financial support for this study was entirely provided by a grant from Instituto de Salud Carlos III through the project PI18/00773 (co-funded by European Regional Development Fund) and the European Union’s Horizon 2020 research and innovation programme under Marie Skłodowska-Curie grant agreement No. 713679 from the Universitat Rovira i Virgili (URV). The funding agreement ensures the authors’ independence in designing the study, interpreting data, and writing and publishing the report. 2022 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Reproducció del document publicat a: https://doi.org/10.1136/bmjopen-2022-064488 BMJ Open, 2022, vol. 12, núm. 11 info:eu-repo/grantAgreement/EC/H2020/713679/EU/MFP cc-by (c) Authors, 2022 info:eu-repo/semantics/openAccess https://creativecommons.org/licenses/by/4.0 BMJ