Patients' values for health states associated with hepatitis c and physicians' estimates of those values

Cotler, Scott J.; Patil, Rajesh V.; McNutt, Robert A.; Speroff, Theodore; Banaad-Omiotek, Geraldine; Ganger, Daniel; Rosenblate, Howard; Kaur, Suman; Cotler, Sheldon

doi:10.1111/j.1572-0241.2001.04132.x

Cited by 40 publications

(30 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Yet, existing evidence suggests that providers underestimate the relative importance of side effects and other aspects of HCV treatment to patients. [7,31,32] To our knowledge, this is the first quantitative assessment of patients’ preferences for the likely features of what may soon become the dominant treatment for chronic HCV infection: peginterferon plus ribavirin plus a DAA.…”

Section: Discussionmentioning

confidence: 99%

Patients’ Willingness to Accept the Risks and Benefits of New Treatments for Chronic Hepatitis C Virus Infection

Kauf

Mohamed

Hauber

et al. 2012

Patient-Patient-Centered-Outcome-Res

View full text Add to dashboard Cite

BackgroundSome patients with chronic hepatitis C virus (HCV) infection forego treatment due to concerns about treatment efficacy, treatment duration, and side effects.ObjectiveThe purpose of this study was to quantify patient preferences among possible outcomes associated with new, direct-acting antiviral agents (DAAs) for the treatment of HCV infection and determine which treatment features are most important to patients in making treatment decisions.MethodsAdult participants with a self-reported physician diagnosis of HCV infection in five countries completed a web-enabled, choice-format conjoint analysis survey. The survey presented participants with 20 treatment-choice questions. Each treatment-choice question included a pair of hypothetical treatment profiles with varying levels of six attributes: treatment duration; chance of getting rid of the virus completely (i.e. likelihood of a sustained virologic response [SVR]); weeks on an additional, third medicine (i.e. a DAA); risk of a severe rash; risk of severe anemia; and number of times a day the third medicine is taken. Treatment-choice questions were based on a predetermined experimental design with known statistical properties. Random-parameters logit was used to estimate preference weights for all attribute levels and the mean relative importance of each attribute.Results284 participants completed the survey. Likelihood of an SVR was the most important outcome to participants, followed by severe anemia risk, severe rash risk, therapy type (a combination of total weeks of treatment and weeks on the third medicine), and dosing of the third medicine. Controlling for other factors, preferences were similar across all therapy types examined.ConclusionPatients with HCV infection indicate a willingness to accept an increased risk of side effects for sufficient improvement in the likelihood of treatment response.Electronic Supplementary MaterialSupplementary material is available for this article at 10.1007/BF03262498 and is accessible for authorized users.

show abstract

Section: Discussionmentioning

confidence: 99%

Patients’ Willingness to Accept the Risks and Benefits of New Treatments for Chronic Hepatitis C Virus Infection

Kauf

Mohamed

Hauber

et al. 2012

Patient-Patient-Centered-Outcome-Res

View full text Add to dashboard Cite

show abstract

“…Physicians aware of the availability of HCV treatment tended to overestimate the efficacy of interferon and ribavirin therapy, citing response rates in up to 70% [19,22]. In two studies, healthcare providers expressed significant concerns about adverse effects of antiviral therapy, which largely mirrored patient responses [28,30]. In one study, physicians indicated a willingness to suggest treatment if response rates exceeded 60% [37].…”

Section: Treatmentmentioning

confidence: 98%

“…Using a visual analogue scale to rate the impact of hepatitis C and its treatment on health states, physicians rated disease-related symptoms and severity (i.e., presence of cirrhosis) as significantly detrimental, with mild symptoms or the presence of asymptomatic cirrhosis being perceived as less negative than the side effects of antiviral treatment [37]. Using a similar approach, Cotler et al compared attitudes of patients with those of their treating physicians [30]. While physicians tended to underestimate the impact of mild disease, they overestimated the potential negative effect of cirrhosis and/or advanced disease on patients.…”

Section: Provider Attitudesmentioning

confidence: 98%

“…While physicians tended to underestimate the impact of mild disease, they overestimated the potential negative effect of cirrhosis and/or advanced disease on patients. The hepatologists had a lower threshold for recommending therapy than patients asked about the acceptance of therapy who were enrolled in this study [30].…”

Section: Provider Attitudesmentioning

confidence: 99%

“…In 20 investigations, either the target population was randomly selected or the entire designated population was contacted for participation [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29]. Successful recruitment, defined as at least 75% enrollment, was reported by five of the cross-sectional studies, all but three of which relied on convenience sampling [16,17,26,30,31].…”

Section: Target Groups and Recruitmentmentioning

confidence: 99%

See 2 more Smart Citations

A Systematic Review of Provider Knowledge of Hepatitis C: Is it Enough for a Complex Disease?

2007

View full text Add to dashboard Cite

As studies indicate that patients with hepatitis C face poor provider knowledge and even stigmatization, we conducted a systematic review of provider knowledge about and attitudes toward hepatitis C. We searched Medline for original studies between 1990 and 2005. Articles were abstracted to define target population, recruitment strategies, study design, and key findings. Twenty-six publications performed in nine countries were identified. Whereas studies demonstrated an understanding of the nature of hepatitis C, significant knowledge deficits existed related to natural history, diagnostic approaches, and treatment. The relevance of simple measures, such as vaccinations against hepatitis A and B, was underappreciated. While providers were aware of risk factors for the disease, there were substantial misperceptions, with 5%-20% of providers considering casual contact as a risk for disease acquisition. We conclude that while healthcare providers understand the nature of hepatitis C, important knowledge gaps persist, which may constitute barriers to appropriate therapy.

show abstract

Survival benefit needed to undergo chemotherapy: Patient and physician preferences

Vaz-Luís

O’Neill

Sepucha

et al. 2017

Cancer

View full text Add to dashboard Cite

BACKGROUND Prior studies suggested that most patients with early stage breast cancer (BC) were willing, for modest survival benefits, to receive 6 months of adjuvant cyclophosphamide, methotrexate, and 5-fluorouracil, an older regimen that is infrequently used today. We examined preferences regarding the survival benefit needed to justify 6 months of a contemporary chemotherapy regimen. METHODS E5103 was a phase III trial which randomized BC patients to receive standard adjuvant doxorubicin, cyclophosphamide and paclitaxel with either bevacizumab or placebo. Serial surveys to assess quality of life were administered to patients enrolled between 01/01/2010 and 06/08/2010. Survival benefit needed to justify 6 months of chemotherapy by patients was collected at the 18 month assessment. A parallel survey was sent to physicians who had enrolled patients on the study. RESULTS Of 519 patients who had not withdrawn at a timepoint prior to 18 months, 87.8% responded to this survey. 175 (16%) physicians participated. We found considerable variation in patients’ preferences particularly for modest survival benefits: for 2 months of benefit, 57% would consider 6 months of chemotherapy, whereas 96% of patients would consider 6 months of chemotherapy for 24 months. Race and education were associated with choices. Physicians who responded were less likely to accept chemotherapy for modest benefit. CONCLUSIONS Among patients who received contemporary adjuvant chemotherapy in a randomized controlled trial, we found substantial variation in preferences regarding benefit worth undergoing chemotherapy. Differences between patients’ and physicians’ choices were also apparent. Eliciting preferences regarding risks and benefits of adjuvant chemotherapy is critical.

show abstract

Patients' values for health states associated with hepatitis c and physicians' estimates of those values

Abstract: There was little agreement between patients' preference values about hepatitis C and their physicians' estimates of those values. Utility analysis could facilitate shared decision making about hepatitis C.

Cited by 40 publications

References 0 publications

Patients’ Willingness to Accept the Risks and Benefits of New Treatments for Chronic Hepatitis C Virus Infection

Patients’ Willingness to Accept the Risks and Benefits of New Treatments for Chronic Hepatitis C Virus Infection

A Systematic Review of Provider Knowledge of Hepatitis C: Is it Enough for a Complex Disease?

Survival benefit needed to undergo chemotherapy: Patient and physician preferences

Contact Info

Product

Resources

About