Client preferences in noncommunicable diseases management in Australia: A scoping review

Noncommunicable diseases (NCD) are the leading causes of mortality in Australia. Understanding clients' preferences is essential to implement effective care models that revitalize utilization of services. This study aims to review existing evidence on client preferences of service delivery among people with NCD in Australia. We followed PRISMA extension for scoping review. Articles conducted with discrete choice experiment were included. Clients with NCD in general or one of the five major diseases: cardiac diseases, diabetes, cancer, chronic respiratory diseases, and mental health disorders. We used the Differentiated Service Delivery Framework to synthesize the findings. Clients expressed a preference for better-trained health workers to handle sample collection and referrals rather than doing it themselves. For polygenic cancer testing, clients preferred primary care physicians over genetic specialists. There was a preference for a model of care that engaged clients in the decision-making process, safe, comprehensive, effective, and affordable services delivered closer to the community, and exhibited shorter waiting times to receive care. Clients preferred face-to-face presence for anxiety and depression screening, polygenic testing for cancer, and follow-up care for breast cancer survivor. Clients preferred less frequent follow-up appointments except those with NCD that needs close follow-up. Clients need a health system that prioritizes patient-centered and community-based models that enhance accessibility, affordability, and safety. Reducing wait times, offering flexible follow-ups and face-to-face services may improve patient satisfaction, trust, and treatment adherence. Failing to align services with patient preferences may lead to lower engagement and reduce healthcare effectiveness.