First-Hand Experience and the Value of Telerehabilitation for Chronic Knee Pain: A Discrete Choice Experiment Nested in a Randomised Controlled Trial

OBJECTIVE: To assess whether first-hand experience of receiving physical therapy via telerehabilitation affected patient preferences and willingness to pay for telerehabilitation.

DESIGN: Discrete choice experiment nested within a randomised controlled trial.

METHODS: We recruited 319 Australian adults aged 45 years or over, with chronic knee pain consistent with osteoarthritis, who had completed a clinical trial where they were randomised to receive physical therapy via telerehabilitation or in-person. Participants were presented hypothetical scenarios and asked to choose between physical therapy delivered via telerehabilitation or in-person. Each scenario presented seven attributes of consultations at varying levels. Data were analysed using a generalised multinomial logit and latent class models.

RESULTS: There were 164 participants from the in-person trial arm (80% of those randomised) and 155 from the telerehabilitation arm (82% of those randomised) who participated. Participants in the telerehabilitation arm (i.e. with first-hand experience of telerehabilitation) were willing to pay AU$ 87.49 [95% CI: 72.83, 102.14] more than people in the in-person arm for telerehabilitation consultations (all other attributes fixed at reference values for categorical variables and at mean values for continuous variables). Four subgroups were identified. In the telerehabilitation arm, 105 (68% of 155) participants preferred telerehabilitation and 50 (32%) preferred in-person consultations. In the in-person arm, 63 (39% of 164) held a strong preference for in-person consultations and 101 (61%) had a mild preference for in-person consultations.

CONCLUSION: People with first-hand experience using telerehabilitation for physical therapy expressed a greater willingness to use and pay for it than people who experienced in-person care.