Patient preferences for primary cardiovascular care in Quebec [Discrete choice experiment]

Cardiovascular diseases and their risk factors are leading causes of morbidity and mortality worldwide, and are among the top reasons for primary care visits. Little is known about patient preferences for primary care in the context of chronic conditions. This study aimed to investigate the effect of key organizational features identified by patients and providers on patients’ choice of a preferred primary care practice to receive cardiovascular care.A discrete choice experiment survey was completed by a weighted online sample of Quebec residents aged 35 and over, and having or being at risk of cardiovascular disease (with hypertension, dyslipidemia, or diabetes excluding gestational diabetes). Respondents completed one of two blocks of nine choice sets by indicating, among three hypothetical primary care practice alternatives in each choice set, their preferred and second-most preferred options. Alternatives were differentiated on the basis of five key attributes that were identified as priorities in an earlier Delphi study: 1) listening to and respecting care preferences; 2) providing personalized information; 3) 24-to-48-hour accessibility in the event of a problem; 4) continuity of care; and 5) up-to-date clinical skills. Each attribute could be assigned a high, moderate or low level. After the discrete choice experiment, perceived task difficulty was assessed by using a standard user metric known as the Single Ease Question, a 7-point rating scale from 1-“very difficult” to 7-“very easy”. Respondents also answered sociodemographic and health-related questions, most of which were taken from the Canadian Community Health Survey, an annual cross-sectional survey from Canada’s national statistical office. Health literacy was measured by using the BRIEF Health Literacy Screening Tool, and readiness to change lifestyle was measured using 1-to-10 Readiness Rulers.The study was approved by the University of Montreal Hospital Research Centre’s research ethics committee (project number 17.305). Data collection took place from November 5 to November 12, 2021 and was stopped after 501 completed questionnaires were obtained.