Patient Preferences Of Treatments Among Women With Metastatic Breast Cancer: Results From A Conjoint Analysis Study

Abstract

tion between items while indicating how strongly an item is preferred. This study investigated the use of MaxDiff as a means of determining patient-reported importance of medication treatment attributes. Methods: MaxDiff was used in a survey of rheumatoid arthritis (RA) patients to determine the importance and relative rank of specific attributes of RA treatments. The following attributes were selected based upon literature review and opinions of the research team: 1) Reduces pain; 2) Potential side effects; 3) How often treatment taken; 4) How treatment is given; 5) Where treatment is given; 6) Personal costs; 7) Works quickly; 8) How long treatment effects last; 9) Keeps disease from getting worse; and 10) Improves physical abilities. Respondents were shown 10 sets of 4 attributes and, for each set, were asked to indicate the RA treatment attribute that was most important and least important to them. The attribute sets were selected using an experimental design that showed each attribute an equal number of times and in different order within the sets. Hierarchical Bayesian techniques were used to derive respondent-level attribute importance scores and, based on the importance scores a relative rank order was developed for each attribute. Results: Based on 291 surveys, MaxDiff attribute importance scores ranged from 13 to 209 with higher scores indicating increased importance. Preventing the disease from getting worse, improving physical abilities, and reduction in pain were the most important RA treatment attributes, all having scores > 195, while the 'how', 'when', and 'where' treatment administration attributes were the least important, all having scores < 15. ConClusions: MaxDiff importance scores demonstrated discrimination among attributes and respondents and should be considered as an alternative to more traditional ranking and rating approaches.

Improving palbociclib adherence among women with metastatic breast cancer using a CONnected CUstomized Treatment Platform: A pilot study

“…According to a prior survey of MBC patients, across all oral treatment medications, forgetfulness (41.3%) was the most common reason for non-adherence, followed by side effects (36.5%). 16 Medications with complex dosing schedules such as palbociclib are more difficult to manage and can increase adherence issues, especially in those with forgetfulness. The most common CDK4/6i adverse event is hematologic toxicities, primarily neutropenia; but this is usually uncomplicated and managed with dose interruption and/or reduction.…”

“…The most common CDK4/6i adverse event is hematologic toxicities, primarily neutropenia; but this is usually uncomplicated and managed with dose interruption and/or reduction. While patients with MBC are often willing to accept additional side effects such as fatigue or nausea for survival gains, 16,17 20.1% of patients reduce dose within the first 6 cycles of treatment initiation predominantly due to side effects. 18 Permanent discontinuation of CDK4/6i due to grade 3-4 treatment-related adverse events were reported in 6 to 7.5% of patients.…”

Pilot study evaluating feasibility and utility of pharmacist-driven oral antineoplastic agent monitoring program

“…OAA utilization by oncologists has risen to 30%-35% of all chemotherapy in 2015 from 5% in 2003. [2][3][4][5][6] However, OAA therapy has challenges including adverse events and adherence. Patients taking OAAs must assume responsibilities for accurate medication administration along with between-visit symptom monitoring and management.…”

“Interventions to increase adherence to oral therapies in breast cancer patients: A systematic review based on the behavior change technique taxonomy”

“…7,23,24 In recent years many new interventions have been designed or implemented in order to tackle the issue of non-adherence, and, to our knowledge, these new efforts have not been yet systematically reviewed. Furthermore, past systematic reviews 7,22,23 focused specifically on interventions aimed at increasing endocrine therapy adherence, thus excluding other forms of oral therapy prescribed for BC. In the present review we will provide a more complete overview of the available scientific literature by updating the work carried out in the past and including studies addressing adherence to oral therapies.…”

“…The interaction of clinical, demographic, psychosocial and healthcare-related factors are known to influence BC patients' medication-taking behaviors, and may act as barriers or as facilitators of adherence. 3 One of the most frequently reported obstacles to adherence is the occurrence of unpleasant side effects caused by the medications (e.g., joint aches, hot flushes, vaginal dryness, weight gain, lack of energy, depression, mood swings, 21,22 but other factors have also been reported, including concerns about long-term effects associated with medications (e.g., concerns of its toxicity, skepticism about benefits), a reduced perception of urgency in taking the prescribed medications, and not feeling sufficiently supported by health professionals. 3,5 Given the clinical and economic implications of nonadherence, 12,15,17,19 the development and the implementation of interventions aiming at increasing adherence to oral therapies in BC patients is of great relevance.…”