Patient Preferences for Long-Term Implant Care in Cochlear, Glaucoma and Cardiovascular Diseases

Sabine Schulz; Laura Harzheim; Constanze Hübner; Mariya Lorke; Saskia Jünger; Annika Buchholz; Stefanie Frech; Melanie Steffens; Christiane Woopen

doi:10.3390/ijerph20146358

Patient Preferences for Long-Term Implant Care in Cochlear, Glaucoma and Cardiovascular Diseases

Int J Environ Res Public Health. 2023 Jul 13;20(14):6358. doi: 10.3390/ijerph20146358.

Authors

Sabine Schulz¹, Laura Harzheim¹, Constanze Hübner², Mariya Lorke³, Saskia Jünger⁴, Annika Buchholz⁵, Stefanie Frech⁶, Melanie Steffens⁵, Christiane Woopen²

Affiliations

¹ Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health (CERES), University of Cologne and University Hospital of Cologne, Universitätsstraße 91, 50931 Cologne, Germany.
² Center for Life Ethics, University of Bonn, 53113 Bonn, Germany.
³ Faculty of Engineering and Mathematics, University of Applied Sciences and Arts (HSBI), 33619 Bielefeld, Germany.
⁴ Department of Community Health, University of Applied Health Sciences Bochum, Gesundheitscampus 6-8, 44801 Bochum, Germany.
⁵ Department of Otolaryngology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
⁶ Department of Ophthalmology, Rostock University Medical Center, Doberaner Str. 140, 18057 Rostock, Germany.

Abstract

In the process of developing and implementing innovative implant technologies the consideration of patient preferences can be beneficial for patients, doctors and developers. Nevertheless, in existing literature, there is still scarce knowledge of patients' perspectives on long-term implant care. In this study, three discrete choice experiments (DCEs) were conducted in the context of cochlear implants (CI, n = 92), glaucoma implants (GI, n = 21) and cardiovascular implants (CVI, n = 23), examining the relative importance of attributes of long-term implant care from the patients' perspective. The participants chose between differently shaped options for implant-related care. The attributes of these care options were generated and selected based on previous literature reviews, group discussions and a diary study with patients. The choice data were analyzed via binary logit regression. In CI-DCE, the technological compatibility of the implant with newer implant models, accessories or devices from other manufacturers was highly valued by participants, whereas in GI-DCE the (in)dependency on glaucoma medication post-implantation had the greatest influence on participants' choice behavior. In CVI-DCE, the attribute with the highest relative importance related to the means of securing long-term treatment success. In all three DCE, shared decision making was relatively important for participants. Our results emphasized the importance of an adequate transfer of technological advancements in implant care for promoting patient benefits, such as the availability of comprehensible, understandable, high-quality information about current developments. Similarly, promoting technological health literacy and further pushing the technological compatibility, durability and safety of implants are directions for future implant development in accordance with patients' preferences. Therefore, the participation of implant wearers in the development process is encouraged.

Keywords: compatibility; decision making; durability; implant failure; information needs; reimplantation; sustainability; technological progress; treatment success.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cardiovascular Diseases* / surgery
Choice Behavior
Humans
Patient Preference
Physicians*

Grants and funding

This research was funded by the Federal Ministry of Education and Research, Germany (Bundesministerium für Bildung und Forschung, BMBF), grant number 03ZZ0923D. The sponsor did not influence the conception or course of the study nor the reporting of results.