‘Tablet burden’ in patients with metastatic breast cancer

Milić, Marina; Foster, A.; Rihawi, Karim; Anthoney, Alan; Twelves, Chris

doi:10.1016/j.ejca.2015.11.015

Cited by 13 publications

(11 citation statements)

References 19 publications

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“…Polypharmacy (PP) is a burden in elderly patients with cancer. 1,2 Moreover, the prevalence of PP in elderly patients is a risk factor for adverse drug reactions. 3 Kotlinska-Lemieszek et al 4 conducted a cross-sectional study in patients with PP and found that 2282 patients with advanced cancer with pain treated according to the World Health Organization (WHO) 3-step ladder for cancer pain relief were included.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Polypharmacy in Elderly Patients With Cancer Pain

Morio

Maeda²,

Yokota

et al. 2019

Am J Hosp Palliat Care

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Objective: Polypharmacy (PP) is a burden in elderly patients with cancer pain; however, risk factors for PP remain unclear. The purpose of this study was to investigate the risk factors for PP in this patient population. Methods: We retrospectively reviewed the medical charts of patients aged 65 years with cancer pain who were treated at Osaka University Hospital between February 2014 and June 2016 according to the World Health Organization 3-step ladder for cancer pain relief. We defined PP as 5 medications and conducted exploratory research to examine the association between PP and patient characteristics. Performance status (PS) was estimated according to the Eastern Cooperative Oncology Group system and is categorized as good PS (0-1) and poor PS (2-4). Results: We reviewed 206 patients (122 men and 84 women) with a median age of 71 years (range, 65-89 years) and found that 174 patients (84.5%) had PP. In multivariate logistic analysis, PP was significantly associated with an increased number of comorbidities (odds ratio [OR]: 4.93, 95% confidence interval [

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Section: Introductionmentioning

confidence: 99%

Risk Factors for Polypharmacy in Elderly Patients With Cancer Pain

Morio

Maeda²,

Yokota

et al. 2019

Am J Hosp Palliat Care

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“…Content analysis27 enabled us to identify seven major types of preference (table 2). We assigned 130 studies (85 %) to one of these types of preference and 22 (15 %) studies37 39–57 to two types of preference. Terminology (eg, preferences, views and perspectives) and concepts (eg, trade-offs, decision regret and goal setting) varied substantially among studies.…”

Section: Resultsmentioning

confidence: 99%

“…The only intervention study in the evidence map (113) used a cluster-randomised design to evaluate whether structured priority-setting consultations led to a sustainable reconciliation of diverging physician–patient views on the importance of health problems. Overall, content analysis of this evidence cluster revealed five key themes: (1) patients’ prioritisation of their multiple health problems (20/34),30 45 47 54 83–98 as an example of which patients were asked how they prioritised their osteoarthritis over their other conditions,97 (2) patients’ preferences regarding self-management of their medications (8/34)42 43 47 54 99–102 and, for instance, its association with treatment adherence,42 (3) patients’ self-care behaviours (3/34)44 55 103 aimed at accomplishing their life goals,44 (4) characteristics of eHealth support tools (2/34)30 104 to help patients self-manage their multiple health conditions104 and (5) changes in patients’ choices resulting from changing circumstances (2/34) 29 30…”

Section: Resultsmentioning

confidence: 99%

“…Thirty-two studies (22 %) investigated a variety of treatment preferences concerning (1) medication (13/32),37 41–43 47 49 53 54 105–108 perhaps for a specific blood pressure-lowering drug due to its characteristics (eg, effects and dose schedule),106 (2) dialysis as a treatment option in end-stage renal disease (6/32),48 109–113 (3) surgery (4/32),114–117 such as a decision in favour of implantable cardioverter-defibrillators or joint replacement, (4) chemotherapy (5/32),35 57 118–120 for which studies may have examined preferences in adjuvant cancer treatments and (5) non-pharmacological/conservative interventions (3/32),121–123 such as studies exploring preferences for activity interventions 121…”

Section: Resultsmentioning

confidence: 99%

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Health-related preferences of older patients with multimorbidity: an evidence map

et al. 2019

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ObjectivesTo systematically identify knowledge clusters and research gaps in the health-related preferences of older patients with multimorbidity by mapping current evidence.DesignEvidence map (systematic review variant).Data sourcesMEDLINE, EMBASE, PsycINFO, PSYNDEX, CINAHL and Science Citation Index/Social Science Citation Index/-Expanded from inception to April 2018.Study selectionStudies reporting primary research on health-related preferences of older patients (mean age ≥60 years) with multimorbidity (≥2 chronic/acute conditions).Data extractionTwo independent reviewers assessed studies for eligibility, extracted data and clustered the studies using MAXQDA-18 content analysis software.ResultsThe 152 included studies (62% from North America, 28% from Europe) comprised 57 093 patients overall (range 9–9105). All used an observational design except for one interventional study: 63 (41%) were qualitative (59 cross-sectional, 4 longitudinal), 85 (57%) quantitative (63 cross-sectional, 22 longitudinal) and 3 (2%) used mixed methods. The setting was specialised care in 85 (56%) and primary care in 54 (36%) studies. We identified seven clusters of studies on preferences: end-of-life care (n=51, 34%), self-management (n=34, 22%), treatment (n=32, 21%), involvement in shared decision making (n=25, 17%), health outcome prioritisation/goal setting (n=19, 13%), healthcare service (n=12, 8%) and screening/diagnostic testing (n=1, 1%). Terminology (eg, preferences, views and perspectives) and concepts (eg, trade-offs, decision regret, goal setting) used to describe health-related preferences varied substantially between studies.ConclusionOur study provides the first evidence map on the preferences of older patients with multimorbidity. Included studies were mostly conducted in developed countries and covered a broad range of issues. Evidence on patient preferences concerning decision-making on screening and diagnostic testing was scarce. Differences in employed terminology, decision-making components and concepts, as well as the sparsity of intervention studies, are challenges for future research into evidence-based decision support seeking to elicit the preferences of older patients with multimorbidity and help them construct preferences.Trial registration numberOpen Science Framework (OSF): DOI 10.17605/OSF.IO/MCRWQ.

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“…Eleven patient preference questionnaires that most closely aligned with the objectives of this project were identified from the literature; [26][27][28][29][30][31][32][33][34][35][36] however, none of them evaluated patient preference and dosing schedules in a manner suitable for our aims. After reviewing the literature and the 11 questionnaires, the following concepts were identified as potentially relevant to our measure: symptom relief; effectiveness; ease of use/convenience/bother; impact on daily life; and medication preference.…”

Section: Literature Reviewmentioning

confidence: 99%

<p>Assessing Preferences for Rare Disease Treatment: Qualitative Development of the Paroxysmal Nocturnal Hemoglobinuria Patient Preference Questionnaire (PNH-PPQ©)</p>

Kaiser¹,

Yount²,

Martens³

et al. 2020

PPA

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Purpose: To develop a patient preference questionnaire (PPQ) assessing eculizumab and ravulizumab treatment for paroxysmal nocturnal hemoglobinuria (PNH). Patients and Methods: The development of the PNH-PPQ © was consistent with Food and Drug Administration guidelines for patient-reported outcome measure development, and included 1) a targeted literature review; 2) PNH expert clinician input on treatment preferences; 3) review of existing qualitative data on the PNH treatment and disease experience; 4) concept elicitation interviews with 8 PNH patients who received eculizumab and/or ravulizumab; 5) translatability review; and 6) cognitive debriefing with 5 patients. Interview participants were recruited through a United Kingdom PNH patient advocacy group and a Canadian clinical site involved in clinical trial ALXN1210-PNH-302. Results: Six themes were identified as most relevant to the PNH treatment experience from the concept elicitation interviews: disease symptoms (n=8/8); treatment frequency (n=7/8); quality of life impact of treatment/disease (n=7/8); treatment burden (n=7/8); treatment efficacy (n=5/8); and treatment side effects (n=5/8). An initial list of 88 preference questions was reduced to 11 highly relevant and non-redundant questions reflecting the 6 themes. Cognitive interview participants unanimously agreed that the PNH-PPQ instructions were clear; response options were understandable, easy to use, and provided enough choices; and the questions captured the factors that inform treatment preferences. Discussion: When new drugs have similar efficacy to existing medications, documenting patient preferences is important for confirming patient benefit from the new medication. Understanding what matters most to patients is essential for delivering patient-centered care and may play a particularly significant role in treatment decision making. The availability of such a tool may be especially important as new orphan drugs are developed and patients with rare diseases have more than one treatment option to consider. Conclusion: The PNH-PPQ provides a patient-centered approach for evaluating preferences for the treatment of PNH. The PNH-PPQ has subsequently assessed patient preference in the clinical trial sub-study ALXN1210-PNH-302s.

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‘Tablet burden’ in patients with metastatic breast cancer

Cited by 13 publications

References 19 publications

Risk Factors for Polypharmacy in Elderly Patients With Cancer Pain

Risk Factors for Polypharmacy in Elderly Patients With Cancer Pain

Health-related preferences of older patients with multimorbidity: an evidence map

<p>Assessing Preferences for Rare Disease Treatment: Qualitative Development of the Paroxysmal Nocturnal Hemoglobinuria Patient Preference Questionnaire (PNH-PPQ©)</p>

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