Patient Preferences for Lung Cancer Treatment: A Qualitative Study Protocol Among Advanced Lung Cancer Patients

Abstract

Introduction: Lung cancer is the deadliest and most prevalent cancer worldwide. Lung cancer treatments have different characteristics and are associated with a range of benefits and side effects for patients. Such differences may raise uncertainty among drug developers, regulators, payers, and clinicians regarding the value of these treatment effects to patients. The value of conducting patient preference studies (using qualitative and/or quantitative methods) for benefits and side effects of different treatment options has been recognized by healthcare stakeholders, such as drug developers, regulators, health technology assessment bodies, and clinicians. However, evidence-based guidelines on how and when to conduct and use these studies in drug decision-making are lacking. As part of the Innovative Medicines Initiative PREFER project, we developed a protocol for a qualitative study that aims to understand which treatment characteristics are most important to lung cancer patients and to develop attributes and levels for inclusion in a subsequent quantitative preference survey.Methods: The study protocol specifies a four-phased approach: (i) a scoping literature review of published literature, (ii) four focus group discussions with stage III and IV Non-Small Cell Lung Cancer patients, (iii) two nominal group discussions with stage III and IV Non-Small Cell Lung Cancer patients, and (iv) multi-stakeholder discussions involving clinicians and preference experts.Discussion: This protocol outlines methodological and practical steps as to how qualitative research can be applied to identify and develop attributes and levels for inclusion in patient preference studies aiming to inform decisions across the drug life cycle. The results of this study are intended to inform a subsequent quantitative preference survey that assesses patient trade-offs regarding lung cancer treatment options. This protocol may assist researchers, drug developers, and decision-makers in designing qualitative studies to understand which treatment aspects are most valued by patients in drug development, regulation, and reimbursement.

Patient Preferences for Multiple Myeloma Treatments: A Multinational Qualitative Study

“…To understand the key characteristics of importance to MM patients, a qualitative study was completed in three phases ( Figure 1 ). Several preference studies attest to the usefulness of qualitative methods with patients and advocate for the use of literature reviews to inform the development of attributes and levels ( 31 , 39 – 41 , 44 ). Therefore, this study involved three phases, whereby each phase informed the subsequent phase ( Figure 1 ): (i) a scoping literature review, (ii) discussions with MM patients using Nominal Group Technique (NGT), and (iii) a combined quantitative and qualitative thematic analysis involving multi-stakeholder discussions with patients, patient organizations, clinicians, and preference research experts.…”

“…Therefore, attributes of key importance to patients may align decision-making with patient's perspectives both in the individual treatment decision-making context (16)(17)(18), as well as in decision-making regarding drug development, authorization, and reimbursement. Attribute levels are the values or categories used to characterize the performance of a treatment (31). As qualitative methods provide in-depth and meaningful information from patients, their use is recommended for the development of attributes and levels.…”

Key Determinants of Health-Related Quality of Life Among Advanced Lung Cancer Patients: A Qualitative Study in Belgium and Italy

“…The present paper presents a secondary data analysis of focus group discussions (FGDs) with LC patients. A primary analysis of the discussions, describing overarching themes of treatment features of importance to LC patients has been published elsewhere ( Petrocchi et al, 2021 ), as well as detailed information regarding the applied qualitative methodologies and limitations ( Durosini et al, 2021 ). However, a specific and in-depth analysis of how LC patients perceive their HRQL, and what they consider to be the treatment- and disease-related factors influencing their HRQL was out of scope in the abovementioned papers.…”

“…Inclusion and exclusion criteria for the FGDs were defined and described in the protocol paper ( Durosini et al, 2021 ). In particular, the following inclusion criteria were applied: 1) in treatment patients with a histological or cytological diagnosis of NSCLC stage III or IV as classified by the Union for International Cancer Control TNM Classification of Malignant Tumors (UICC TNM VIII Edition); 2) adult patients (≥18 years old).…”

Patient Preferences for Lung Cancer Treatments: A Study Protocol for a Preference Survey Using Discrete Choice Experiment and Swing Weighting

“…The selection of the attributes and levels of the DCE and the SW arise from a previous qualitative study ( 28 , 29 ). Through focus-group discussions conducted in Belgium and in Italy, patients highlighted themes reflecting positive effects, or expected gains of treatment, and negative effects or adverse events that negatively impacted their daily functioning.…”