Tuberculosis Patients’ Preferences for Improving Tuberculosis Care in Nepal: A Discrete Choice Experiment

  • Tara P Aryal (Speaker)
  • Kedar P Baral (Contributor to Paper or Presentation)
  • Jeevan K Thapa (Contributor to Paper or Presentation)
  • Gc, V. (Contributor to Paper or Presentation)

Activity: Talk or presentation typesOral presentation


Background: Understanding patient’s preferences for tuberculosis (TB) care is crucial to develop patient-centred TB care. However, there is a paucity of published literature to determine patient preferences for managing drug-sensitive TB in Nepal.
Methods: Using the results of a review of published literature and conducting qualitative patient interviews, we designed a discrete choice experiment (DCE). The choice experiment was completed by 133 participants aged 18 years or above with pulmonary TB. Participants were recruited from 20 public TB treatment centres in Nepal between December 2022 and February 2023. The DCE study included six characteristics (attributes) of TB care (patient card, sex of healthcare provider, provision of transportation incentives, provision of psychosocial support, waiting time, and types of TB care provider). In 24 choice tasks, participants selected their preferred option from 2 hypothetical care models. As part of the study, participants' socio-demographic characteristics including their health status, such as smoking and HIV status, were also collected. The analysis used a conditional logit regression model to quantify the individual preference utility associated with each attribute.
Results: Among 133 patients who participated in DCE (97% response rate, mean age of 47 years, 71% male), 83% had pulmonary bacteriologically confirmed (PBC) TB, and 32% were in the intensive phase of treatment. Patient card with instructions, provision of psychosocial support, and waiting time were the significant attributes associated with TB care. Patients highly valued TB care services that have the provision of psychosocial support (β=0.621).
Conclusion: People with TB preferred to be supported by psychosocial interventions, improved patient card, and reduced waiting time. This study provides valuable information for current/future TB control programme package to align with the patient’s preferences.
Period24 Apr 2023
Event title20th Britain-Nepal Academic Council Nepal Study Days
Event typeConference
Conference number20
LocationHuddersfield, United KingdomShow on map
Degree of RecognitionInternational