Every day customers make hundreds of choices, many being relatively simple. Some choices, however, are particularly important as they will have significant effects on future outcomes, such as an individual’s health and wellbeing (Seiders et al. 2015). Traditionally, many of these important decisions were made by “experts” for customers, such that individual customers played a relatively passive role (Berry and Bendapudi 2007; Payne et al. 2008).
In healthcare, choices are often difficult requiring considerable effort and trade-offs. This is the case with chronic diseases such as Cystic Fibrosis (CF) where there is no cure, and the onus is being placed on the healthcare customer to manage their health options (McColl-Kennedy et al. 2017; Sweeney Danaher and McColl-Kennedy 2015). Yet, not all healthcare customers want to have an active role, nor do they undertake the same types of activities, as some involve considerable effort (Sweeney et al. 2015). While McColl-Kennedy et al. (2017) and Sweeney et al. (2015) highlight that healthcare customers engage in activities and interactions with clinicians and family members, their work does not investigate the decision-making process, nor the influence of these other key parties on treatment plan choices.
Decision-making requires healthcare customers to trade-off between alternatives and consider short and long-term consequences, often in contexts of uncertainty (Turner and Coote 2017). To do so, healthcare customers draw on a repertoire of knowledge, skills and abilities. Despite advancements, and recognition of the need to involve patients in decisions, shared decision-making, if implemented at all, is limited to the expert-customer dyad (Joseph-Williams et al. 2014), with little consideration of the influence of others. Hence, multiparty decision-making is not well understood. That is where our two-study research program contributes.
In Study 1 we conducted 25 in-depth interviews with adolescents and adults with CF and their respective parents/partners. This study identified the complexity of choices required to maintain or improve health and wellbeing and a series of choice sets was devised for Study 2 that related to the health treatment plans including use of prescription drugs, exercise therapy, airway clearance regimes, alternative medicines and diet selections.
Pilot work is underway for the discrete choice experiment designed to model multiparty decision-making in health treatment plans (Louviere et al. 2000). The decision partners are the healthcare professionals, parents, partner or others significant to the person with CF. The multidimensional choices are the attributes of the health treatment plans. In this first study of choice modelling in CF, the discrete choices of adults are recorded separately and then jointly with doctors, parents, partners, and friends. This modelling enables better understanding of the preferences of each party in choices and the role others play in influencing the decision. Implications for theory and practice are discussed.