THE GROWING ROLE OF QUALITATIVE

INTERVIEWS IN HEALTH OUTCOMES

RESEARCH GUILLEMOT J1, GAUTHIER A1, HASS B2, BASSO F3, COGNET M1

1Amaris, London, UK 2Boehringer Ingelheim GmbH, Ingelheim, Germany 3Boehringer Ingelheim GmbH, Vienna, Austria

ISPOR 2013 DUBLIN - CP3 PODIUM

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QUALITATIVE INTERVIEWS: INFORMING OUTCOMES

RESEARCH DECISIONS

Traditionally, health outcomes research tends to

use quantitative research methods.

Quantitative research methods provide statistically

measurable outcomes.

Qualitative research is usually associated with market

research and social sciences.

With the increasing complexity of outcomes research, the

influences of human behaviour is becoming more

prominent.

Qualitative interviewing as a method of capturing health

related human behaviour is proving to be a valuable tool.

Green, J. & Britten, N. Qualitative Research and Evidence Based Medicine. BMJ. Volume 316. 1998.

Greenhalgh, T & Taylor, R. Papers that Go Beyond Numbers (Qualitative Research). BMJ. Volume 315. 1998.

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Context Preference study

Disease Hepatitis C (HCV)

Population Physicians and HCV patients

Objective

Identify HCV treatment characteristics most

important to the population

Quantify the relative importance of the

treatment characteristics

Methods Discrete Choice Experiment (DCE)

UNDERSTANDING PATIENT TREATMENT

PREFERENCES IN HCV

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DCE METHODOLOGY

DCE assumes that treatments can be fully described by a set

of characteristics or attributes and that individual preferences

depend solely on the level of each attribute

The first step of a DCE consists of identifying these attributes

Systematic

literature review

Treatment profiles

development

Experts validation Draft treatment

attributes

Interviews

Final treatment

attributes

DCE

(Discrete Choice

Experiment)

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DRAFT TREATMENT ATTRIBUTES LIST

Efficacy

Treatment duration

Treatment administration

Anaemia/fatigue

Dermatological problems

Gastro-intestinal problems

Food requirements

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QUALITATIVE INTERVIEWING APPROACH

Review the selection of treatment attributes

Assess comprehensibility of the questionnaire

• List of themes/topics which must be discussed

• Semi direct: leaves the respondent free to discuss aspects

related to the theme, most relevant to him/her

Topic guide for

semi-direct

interview

• Apply codes to the transcript

• Descriptive, e.g. history of diagnosis experience

• Analytical, e.g. ‘importance of efficacy in treatment choice’

Coding

(qualitative

research)

• Descriptive analytics associated with the appearance of codes

across database

• More complex analysis: across codes

Qualitative

analysis

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FINDINGS ON TREATMENT ATTRIBUTES

The findings confirmed most of the treatment attributes

Patients highlighted neuropsychological problems as a critical aspect

of treatment preferences

The analysis revealed the importance of synergetic effects of treatment

attributes

e.g. Longer treatment duration became less acceptable with high

levels of adverse events.

Data suggested that ‘food requirements’ were the treatment attribute

that mattered the least

Patient 2: ‘In a short duration, you can handle the side effects a

lot more than if it’s just grinding you down.’

Five patients and two physicians were interviewed.

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FINDINGS ON COMPREHENSIBILITY

The interviews revealed the need to clarify some terms intended

to be used in the survey

e.g. Interviewees were asked about their views on receiving

injections. Patients with experience of interferon interpreted

the term 'injection' as ‘interferon injection'

Some respondents were treatment-experienced former

injecting drug users or tattoo enthusiasts: Phobia of needles

were small but great for interferon side effects

Interviewer: What about injecting?

Patient 1: Yeah, that is completely off; I wouldn’t do that and I don’t

want do that. I mean if it was injecting protease inhibitors, I might

do it but as far as interferon is concerned I wouldn’t; I don’t want to

do an interferon-based regime.

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IMPACT OF FINDINGS

On treatment attributes, the findings supported

The inclusion of “neuropsychological problems“ as a treatment

attribute replacing “food requirements”

On comprehensibility, the findings supported

That “treatment administration” needed to be explicitly

explained, i.e. different from the treatment itself

That each treatment attribute needed to be supported with an

extensive explanation

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LIMITATIONS

The qualitative interviews were conducted on a small

population sample

Patients were recruited via HCV patient associations

Interviewees were likely to be more knowledgeable than the

target population

Patients displayed advanced educational backgrounds,

which might have affected the research outcomes

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CONCLUSION

Qualitative interviews were beneficial in order to best

possibly prepare the actual DCE

Patients and physicians explained in detail their preferences

which improved our understanding

The interviews contributed to the selection of treatment

attributes

The question of interdependence between treatment

attributes will be further investigated during the

quantitative phase

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TAKE AWAY MESSAGES

Qualitative research follows strict and valuable methods: a

scientific approach providing worthy outcomes

The approach used is probably extendable to other types

of quantitative projects, e.g. qualitative interviews to ensure

the quality of survey-based research

Barbour, RS. The Role of Qualitative Research in Broadening the ‘Evidence base’ for Clinical Practice. Journal of Evaluation in

Clinical Practice, 6, 2, 1555-163.

Giacomini, MK. The Rocky Road: Qualitative Research as Evidence. EBM. Volume 4. 2001

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TAKE AWAY MESSAGES

Using qualitative interviews

helped better aim the DCE,

therefore improving the quality

of the specificity of the DCE.

Qualitative methods such as

qualitative interviews and

quantitative research can be

used complementarily

Barbour, RS. The Role of Qualitative Research in Broadening the ‘Evidence base’ for Clinical Practice. Journal of Evaluation in

Clinical Practice, 6, 2, 1555-163.

Giacomini, MK. The Rocky Road: Qualitative Research as Evidence. EBM. Volume 4. 2001

A quantitative

approach

captures less

data with

greater precision

A qualitative

approach

captures more

data with less

precision

Q&A SESSION

Thank you for your time.