I patch! Out on the road I switch tubes, because it's faster. But once I'm home I patch, and that's my new spare. I do 3 patches before calling it a day. I also don't patch if a new patch ends up overlapping an old patch, that's too bulky for me. I've never had patches fail. But I like the old-fashioned glue+vulcanized rubber ones.

I learned a handy trick recently to keep track of where the hole is, btw. Once it's located draw a BIG cross over it with a felt-tip pen, instead of a little circle or something. When you sand the tube down a little and especially once the glue is on you can't see details around the hole, but you can still follow the lines you drew and estimate.