Tailoring chemotherapy supply according to patients’ preferences: a quantitative method in colorectal cancer care

Abstract

Objectives: The aim of this study was to conduct a discrete choice experiment with patients affected by colorectal cancer to understand their preferences for different attributes of the chemotherapy supply. Our overall goal is to provide evidence on the relative importance of each attribute in order to tailor chemotherapy supply according to patients' priorities in the design or reorganization processes of cancer services. Methods: Focus groups were used to identify the attributes and levels for the discrete choice experiment. The attributes were: continuity of care, understanding, information, treatment choice, and time for therapy. Respondents were asked to choose between two mutually exclusive hypothetical alternatives of chemotherapy supply. Patients completed the discrete choice experiment along with health-related quality of life and patients' satisfaction questions. Conditional and mixed logistic models were used to analyses the data. Results: Patients with colorectal cancer treated with chemotherapy (n=76) completed the survey. The most important aspects of chemotherapy supply were: "Providing detailed and complete information" and "High ability in understanding" patients. Preferences were also influenced by the availability of a trusted doctor. Except for one attribute (waiting time for therapy), all other characteristics significantly influenced respondents' preferences. Conclusions: Results should support a policy of strengthening medical doctors' capabilities to communicate with patients, providing them complete information and involving them in the clinical decisions. Specifically, the findings should be used to improve current provision of cancer care by identifying areas of preferred intervention from the perspectives of patients in order to tailor the service supply accordingly.

<p>Patient Treatment Preferences for Heart Failure Medications: A Mixed Methods Study</p>

“…Such prioritization of positive treatment outcomes over other factors is also seen in other patient populations, notably those with cancer. 2,3,14 Prior studies evaluating patient HFrEF treatment preferences focus on treatment outcomes and do not directly evaluate other factors such as adverse effects or cost. 6,8,9 In our study, four patients ranked "cost or insurance coverage" or "number of times you take meds daily" Note: All patient-reported questions were asked in layman terms and referred to "medication for your heart" versus heart failure medications.…”

A Systematic Review of Discrete Choice Experiments in Oncology Treatments

“…[38,48,68,87,110]), followed by patients (n = 33, 63%; e.g. [47,59,70,85,109]) and caregivers (n = 4, 8%; [59,61,70,100]). Of the studies including a clinician sample at the qualitative phase, 44% (n = 15) also sought qualitative insights from patients.…”

“…[38,48,70,78,91]) and other concepts (n = 34, 43%; e.g. [36,59,71,80,110]), such as the duration of clinical efficacy or safety evidence for the treatment, experience of the clinician and patient involvement in the decision-making process, and cost (n = 29, 36%; e.g. [40,54,66,79,105]).…”

Patient choice in colorectal cancer treatment – A systematic review and narrative synthesis of attribute‐based stated preference studies

“…Salkeld et al and Rosato et al focused their research on eval-uating cancer services rather than specific treatment options[16,24]. The former analysed surgical services with respect to surgeon experience, communication skills, and nature of surgical centres.…”