Psychosocial factors might hold the key to understanding preference heterogeneity


That patients’ preferences differ is not surprising. But figuring out why is one of the main challenges of integrating the patient voice in decision-making across the medical product life cycle. Some differences might be due to clinical characteristics like age and medical history, and others to psychosocial factors like health literacy or illness perception. A recent PREFER publication underlines how measuring psychosocial factors in patient preference studies can provide valuable information to decision-makers. And provides recommendations and a checklist telling us how to do it.

“Listening to the patient voice is important. But all patients don’t speak with one voice. Patient preference studies is a way of making sure patients are heard in decision-making processes that will ultimately affect their treatment. Explaining why patients’ preferences differ is important to ensure decision-makers have the information they need to include the patient perspective in decisions about what drugs should be developed, if they should be approved, and what they should cost,” says Selena Russo, co-author of a recent Patient Preference and Adherence publication.

Patient preference studies offer a systematic way of integrating the patient perspective in decision-making. To do that, PREFER is working to close knowledge gaps in the methodology. A recent publication helps close this knowledge gap. It helps stakeholders select what psychological constructs and measurements to use. This will support stakeholders as they evaluate how patients form, maintain, change, and negotiate preferences in medical and healthcare contexts. And where patients’ preferences diverge, psychological constructs can help explain why.

From a systematic review of how psychological constructs impact patients' preferences and health-related decisions, and interviews with experts in psychology, medical decision-making and risk communication, the publication identifies 3 classes of recommendations and 11 psychological constructs that should be included in patient preference studies. Most importantly: health literacy, numeracy, illness perception and treatment-related beliefs. In addition, the authors propose a checklist that can help researchers and other stakeholders decide what psychological measurements to include in their patient preference studies. 

“Our results can help researchers and other stakeholders obtain results that can be used to inform decision-making. Enabling implementation of personalised medicine and patient-centred care,” says Dario Monzani, another author of the recent Patient Preference and Adherence paper.

Russo, S., Monzani, D., Pinto, C. A., Vergani, L., Marton, G., Falahee, M., … Pravettoni, G. (2021). Taking into Account Patient Preferences: A Consensus Study on the Assessment of Psychological Dimensions Within Patient Preference Studies. Patient Preference and Adherence, 15, 1331–1345.

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By Anna Holm