Therapy preferences of patients with lung and colon cancer

A discrete choice experiment

authored by
Katharina Schmidt, Kathrin Damm, Arndt Vogel, Heiko Golpon, Michael P. Manns, Tobias Welte, J. Matthias Graf von der Schulenburg
Abstract

Objectives: There is increasing interest in studies that examine patient preferences to measure health-related outcomes. Understanding patients’ preferences can improve the treatment process and is particularly relevant for oncology. In this study, we aimed to identify the subgroup-specific treatment preferences of German patients with lung cancer (LC) or colorectal cancer (CRC). Methods: Six discrete choice experiment (DCE) attributes were established on the basis of a systematic literature review and qualitative interviews. The DCE analyses comprised generalized linear mixed-effects model and latent class mixed logit model. Results: The study cohort comprised 310 patients (194 with LC, 108 with CRC, 8 with both types of cancer) with a median age of 63 (SD =10.66) years. The generalized linear mixed-effects model showed a significant (P<0.05) degree of association for all of the tested attributes. “Strongly increased life expectancy” was the attribute given the greatest weight by all patient groups. Using latent class mixed logit model analysis, we identified three classes of patients. Patients who were better informed tended to prefer a more balanced relationship between length and health-related quality of life (HRQoL) than those who were less informed. Class 2 (LC patients with low HRQoL who had undergone surgery) gave a very strong weighting to increased length of life. We deduced from Class 3 patients that those with a relatively good life expectancy (CRC compared with LC) gave a greater weight to moderate effects on HRQoL than to a longer life. Conclusion: Overall survival was the most important attribute of therapy for patients with LC or CRC. Differences in treatment preferences between subgroups should be considered in regard to treatment and development of guidelines. Patients’ preferences were not affected by sex or age, but were affected by the cancer type, HRQoL, surgery status, and the main source of information on the disease.

Organisation(s)
Institute of Health Economics
Institute of Insurance Business Administration
External Organisation(s)
Hannover Medical School (MHH)
German Center for Lung Research
Type
Article
Journal
Patient preference and adherence
Volume
11
Pages
1647-1656
No. of pages
10
ISSN
1177-889X
Publication date
26.09.2017
Publication status
Published
Peer reviewed
Yes
ASJC Scopus subject areas
Medicine (miscellaneous), Social Sciences (miscellaneous), Pharmacology, Toxicology and Pharmaceutics (miscellaneous), Health Policy
Sustainable Development Goals
SDG 3 - Good Health and Well-being
Electronic version(s)
https://doi.org/10.2147/PPA.S138863 (Access: Open)