Patient preferences for chemotherapies used in breast cancer.

Beusterien, K.; Grinspan, Jessica; Tencer, Thomas; Brufsky, AM; Visovsky, Constance

doi:10.1200/jco.2011.29.15_suppl.e19667

Cited by 3 publications

(3 citation statements)

References 12 publications

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“…Reducing the risk of sensory neuropathy had the largest impact on preferences among grade I/II side effects, and reducing the risk of motor neuropathy had the largest impact on preferences among grade III/IV side effects. These findings are consistent with those of previous research in breast cancer, in which both sensory and motor neuropathies were deemed highly important in terms of predicting preferences [13]. This most likely is attributable to the frequency and prolonged duration of these side effects [14].…”

Section: Discussionsupporting

confidence: 91%

“…When it came to other more severe side effects, such as grade III/IV motor neuropathy, patients were willing to accept a less convenient regimen to avoid an increased risk of these side effects. These results are again consistent with findings in the previous study of patient preferences for chemotherapies used to treat breast cancer [13] as well as a study in which patients with non-small cell lung cancer were more likely to trade less convenience to avoid severe side effects but would choose more convenience if the side effect was mild [15].…”

Section: Discussionsupporting

confidence: 91%

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Use of Conjoint Analysis to Assess Breast Cancer Patient Preferences for Chemotherapy Side Effects

Beusterien¹,

Grinspan

Kuchuk

et al. 2014

The Oncologist

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Objective. Our objective was to evaluate preferences associated with grade I/II and grade III/IV chemotherapy side effects among breast cancer patients receiving chemotherapy. We also assessed trade-offs that patients are willing to make between treatment side effects and the route and schedule of treatment administration. Methods. In this cross-sectional study, patients receiving chemotherapy for breast cancer completed a one-time Web survey. Conjoint analysis was used to elicit preferences for 17 grade I/II and III/IV side effects associated with available chemotherapies and regimens. In the analysis, the risk of each side effect was increased by 5%, holding all others constant, and the respective impact on patient preferences was identified. Results. A total of 102 women participated (mean age 54 6 11). Among the grade I/II side effects, a 5% reduction in the risk of sensory neuropathy, nausea, and motor neuropathy had the highest impact on preferences. Among grade III/IV side effects, motor neuropathy, nausea/vomiting, and myalgia made the most difference. An oral twice-daily regimen was most preferred; however, patients werewillingto receive an intravenous regimen relative to oral to avoid an increased risk of 5% in the majority of side effects. Avoiding an increased chance of grade III/IV motor neuropathy was associated with willingness to tolerate one of the least preferred administration schedules. Conclusion. This study identified relative preferences among both mild/moderate to severe side effects from the patient perspective. Patients appear to be willing to make trade-offs between side effects and different regimens. These findings may help to inform medical decision-making processes. The Oncologist 2014;19:127-134 Implications for Practice: Patient care has shown a gradual shift from a paternalistic model, in which the patient serves a passive role, to a model of shared decision making, in which patients become active participants in their health care plans. The current literature has suggested that this approach can result in increased satisfaction and adherence. In the current study, patients with breast cancer were able to express clear preferences for and make trade-offs among various grade I/II and grade III/IV side effects. Understanding these preferences and incorporating them into their treatment plans for breast cancer patients could lead to substantially improved clinical and quality of life outcomes.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 91%

Use of Conjoint Analysis to Assess Breast Cancer Patient Preferences for Chemotherapy Side Effects

Beusterien¹,

Grinspan

Kuchuk

et al. 2014

The Oncologist

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“…44 Thus, numerous studies examining treatment preferences in breast cancer patients do not include an opt-out choice. 29,45,46 For example, daCosta DiBonaventura et al found that 35% of their sample of mBC patients either had discontinued or were nonadherent to treatment at the time of their study. 29 Similarly, 29% of participants in the study by Lalla et al were not receiving any treatment for mBC at the time of survey completion.…”

Section: Discussionmentioning

confidence: 99%

The Value of Progression-Free Survival in Metastatic Breast Cancer: Results From a Survey of Patients and Providers

MacEwan¹,

Doctor²,

Mulligan³

et al. 2019

MDM Policy & Practice

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Background. Value assessments and treatment decision making typically focus on clinical endpoints, especially overall survival (OS). However, OS data are not always available, and surrogate markers may also have some value to patients. This study sought to estimate preferences for progression-free survival (PFS) relative to OS in metastatic breast cancer (mBC) among a diverse set of stakeholders—patients, oncologists, and oncology nurses—and estimate the value patients and providers place on other attributes of treatment. Methods. Utilizing a combined conjoint analysis and discrete choice experiment approach, we conducted an online prospective survey of mBC patients and oncology care providers who treat mBC patients across the United States. Results. A total of 299 mBC patients, 100 oncologists, and 99 oncology nurses completed the survey. Virtually all patients preferred health state sequences with contiguous periods of PFS, compared with approximately 85% and 75% of nurses and oncologists, respectively. On average, longer OS was significantly ( P < 0.01) preferred by the majority (75%) patients, but only 15% of nurses preferred longer OS, and OS did not significantly affect oncologists’ preferred health state. However, in the context of a treatment decision, whether a treatment offered continuous periods of stable disease holding OS constant significantly affected nurses’ treatment choices. Patients and providers alike valued reductions in adverse event risk and evidence from high-quality randomized controlled clinical trials. Conclusions. The strong preference for observed PFS suggests more research is warranted to better understand the reasons for PFS having positive value to patients. The results also suggest a range of endpoints in clinical trials may have importance to patients.

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Systematic Review of Patient Preference Studies in Non-metastatic Breast Cancer Adjuvant Medication Therapy: Attribute Selection

Homayouni,

Nikfar,

Mokarian Rajabi

et al. 2024

Iran J Pharm Res

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Context: Breast cancer poses significant challenges due to its high incidence and prevalence, necessitating heightened attention. Understanding how patients prioritize different treatment options based on various attributes can assist healthcare decision-makers in maximizing patient utility. The discrete choice experiment, a conjoint method, facilitates preference elicitation by presenting different attributes and choices. This systematic review aims to identify key factors in patient preference research related to adjuvant treatment for early breast cancer characterized by hormone receptor-positive, HER2-negative status. Evidence Acquisition: PubMed, Embase, Web of Science, and Scopus were searched from 01.01.2000 to 31.03.2023. Original English articles reporting patient preferences in adjuvant breast cancer treatment were retrieved based on predefined inclusion and exclusion criteria. Included studies were examined through a narrative synthesis approach, with descriptive statistics employed for analysis. Results: Out of 1163 articles reviewed, four met the inclusion criteria and were conducted in the USA, Canada, and the Netherlands. Attributes extracted from all studies included alopecia, sensory neuropathy, motor neuropathy, myalgia/arthralgia, nausea, vomiting, fatigue, neutropenia, mucositis/stomatitis, hand-foot syndrome, diarrhea, prevention of breast cancer recurrence, osteoporosis, risk of endometrial cancer, joint and muscle pain, fluid retention, libido decrease, hot flashes, ECG monitoring, efficacy, treatment regimen, 5-year invasive disease-free survival (iDFS), dosing schedule, and treatment duration. The most frequently reported attributes were side effects, efficacy, and treatment regimen. Systematic review was commonly used to determine which attributes and levels to include. The minimum number of attributes identified per study was seven, and the maximum was 12. Sample sizes ranged from 102 to 300, with none of the studies mentioning the method of sample size estimation. Ordinary Least Squares, logistic regression, and hierarchical Bayes regression were the most frequent analysis methods. Conclusions: Side effects, 5-year iDFS, and treatment regimen are three attributes identified for conducting discrete choice experiment studies. Utilizing conjoint analysis to assess patient preferences for breast cancer treatment can aid in selecting optimal treatment regimens and improving patient adherence. Moreover, adhering to guidelines for developing experimental designs and conducting data analysis is essential for yielding robust results when employing preference elicitation methods.

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Patient preferences for chemotherapies used in breast cancer.

Cited by 3 publications

References 12 publications

Use of Conjoint Analysis to Assess Breast Cancer Patient Preferences for Chemotherapy Side Effects

Use of Conjoint Analysis to Assess Breast Cancer Patient Preferences for Chemotherapy Side Effects

The Value of Progression-Free Survival in Metastatic Breast Cancer: Results From a Survey of Patients and Providers

Systematic Review of Patient Preference Studies in Non-metastatic Breast Cancer Adjuvant Medication Therapy: Attribute Selection

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