Patient Preferences for Endometriosis Pain Treatments in the United States

PURPOSE Interferon alfa treatment in multiple myeloma marginally improves relapse-free and overall survival. Often it does so at the expense of toxicity and financial cost. If patients are unwilling or unable to participate in the decision of whether to initiate such treatment, known patient preferences can serve as guidelines for the physician. We interviewed myeloma patients in the United States to obtain information that might facilitate medical decision-making. PATIENTS AND METHODS Three hundred fifty-five myeloma patients throughout the United States were interviewed by telephone. Without identifying interferon alfa as the treatment agent, interviewers described potential adverse effects, financial cost, and self-injection procedures. The potential benefits of four treatment choices, derived from a meta-analysis of published data, were presented as gains in remission rate (+10%), remission duration (an additional 4 and 7 months, respectively, for induction and maintenance treatment), and overall survival (an additional 3 and 6 months, respectively, for induction and maintenance treatment). Patients' choices for or against use of the unidentified substance were recorded, and interferon was subsequently disclosed as the treatment. The profiles of patients making different choices were determined using multivariate regression techniques. RESULTS Approximately half of the patients accepted the unidentified treatment if remission and/or survival improved by at least 6 months. Accepters were younger and more likely to have used interferon. Of patients who rejected the unidentified treatment, 25% to 50% would have been willing to accept it if the benefits were > or = 12 months. Test/retest reliability of all choices, determined in 36 cancer patients, was 0.896. CONCLUSION In multiple myeloma, interferon therapy and, by inference, other treatments with comparable features are acceptable to approximately half of the patients if a 6-month gain in relapse-free or overall survival can be expected.

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Relative Importance of Mode of Administration in Treatment Preferences among Plaque Psoriasis Patients in the United States

Journal of Health Economics and Outcomes Research ◽

10.36469/9817 ◽

2016 ◽

Vol 4 (2) ◽

pp. 141-157 ◽

Cited By ~ 3

Author(s):

Steven R. Feldman ◽

Anders Holmen Moeller ◽

Sandra T. Erntoft Idemyr

Keyword(s):

United States ◽

Patient Preferences ◽

Topical Treatment ◽

Treatment Efficacy ◽

Well Being ◽

The United States ◽

Treatment Preferences ◽

Treatment Burden ◽

Mode Of Administration ◽

Oral Agents

Background: Some aspects of psoriasis treatments can negatively influence patients’ quality of life. There is evidence from previous preference-elicitation research in psoriasis that administration characteristics are at least as important as treatment outcomes to patients. Objectives: Our objective was to test the hypothesis that patients’ preferences for reduced disease and treatment burden are as important as preferences around treatment efficacy. We evaluated patient preferences for attributes of psoriasis treatments, including efficacy, tolerability, and mode and frequency of administration. Methods: Adult patients in the United States with a self-reported physician diagnosis of psoriasis completed an online discrete-choice experiment survey. The survey included eight choice questions, each asking respondents to choose between pairs of hypothetical psoriasis medications defined by attributes including efficacy, adverse reactions, and mode and frequency of administration. A random-parameters logit regression model was used to model the preference data. Results from this model were used to calculate respondents’ willingness to trade efficacy for reduced treatment burden. Results: A total of 397 respondents, with a mean self-assessed Psoriasis Activity and Severity Index score of 8.2 (SD, 9.8), provided data for analysis. Improvements in treatment efficacy were more important than improvements in speed of onset and were more important than most increases in the chance of treatment side effects. The maximum possible improvement in treatment efficacy offered in the study was not enough to match the improvements in well being associated with some changes in mode of administration. For example, respondents were willing to accept a reduction in the percentage of patients who achieve clear or almost-clear skin after treatment from approximately 70% to 40% to avoid injections at home and use a topical treatment. Topical treatments were the most preferred option of administration followed by oral agents and intravenous infusion. Conclusions: Psoriasis patients had well-defined preferences for changes in the treatment attributes considered. Avoiding injections in favor of oral or topical treatment was more important to patients than some improvements in efficacy. These findings support previous research regarding the importance of treatment burden relative to outcomes in psoriasis and emphasize the importance of individual patient preferences in determining treatment strategy.

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Shared Decision-Making in Patients With Prostate Cancer in Japan: Patient Preferences Versus Physician Perceptions

Journal of Global Oncology ◽

10.1200/jgo.2016.008045 ◽

2018 ◽

pp. 1-9 ◽

Cited By ~ 4

Author(s):

Ulrike Schaede ◽

Jörg Mahlich ◽

Masahiko Nakayama ◽

Hisanori Kobayashi ◽

Yuriko Takahashi ◽

...

Keyword(s):

Prostate Cancer ◽

United States ◽

Decision Making ◽

Shared Decision Making ◽

Patient Preferences ◽

Treatment Decision ◽

Japanese Patients ◽

The United States ◽

Treatment Decisions ◽

Shared Decision

This article adds the Japanese perspective to our knowledge of shared decision-making (SDM) preferences by surveying patients with prostate cancer (PCA) and physicians in Japan. In 2015, 103 Japanese patients with PCA were asked about their SDM preferences by using an Internet-based 5-point-scale questionnaire. Concurrently, 127 Japanese physicians were surveyed regarding their perceptions of patient preferences on SDM. Drivers of preferences and perceptions were analyzed using univariable ordinal logistic regression and graphing the fitted response probabilities. Although 41% of both patients and physicians expressed and expected a desire for active involvement in treatment decisions (a higher rate than in a similar study for the United States in 2001), almost half the Japanese patients preferred SDM, but only 33% of physicians assumed this was their choice. That is, 29% of Japanese physicians underestimated patients’ preference for involvement in making treatment decisions. Patients with lower health-related quality of life (as measured by the Functional Assessment of Cancer Therapy-Prostate [FACT-P]) expressed a stronger preference for SDM. The study shows that the worse the medical situation, the more patients with PCA prefer to be involved in the treatment decision, yet physicians tend to underestimate the preferences of their patients. Perhaps in contrast to common assumptions, Japanese patients are as interested in being involved in decision making as are patients in the United States.

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Patient Preferences for Injectable Treatments for Multiple Sclerosis in the United States: A Discrete-Choice Experiment

The Patient: Patient-Centered Outcomes Research ◽

10.1007/s40271-015-0136-x ◽

2015 ◽

Vol 9 (2) ◽

pp. 171-180 ◽

Cited By ~ 22

Author(s):

Christine Poulos ◽

Elizabeth Kinter ◽

Jui-Chen Yang ◽

John F. P. Bridges ◽

Joshua Posner ◽

...

Keyword(s):

United States ◽

Multiple Sclerosis ◽

Discrete Choice Experiment ◽

Discrete Choice ◽

Patient Preferences ◽

Choice Experiment ◽

The United States

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PP268 Eliciting Meaningful Patient Preferences In Rare Diseases – Swing Weighting With Immunoglobulin A Nephropathy Patients In The United States And China

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462320001476 ◽

2020 ◽

Vol 36 (S1) ◽

pp. 24-24

Author(s):

Kevin Marsh ◽

Nancy Zaour ◽

Kerrie-Anne Ho ◽

Ankit Joshi ◽

Rachel Lo ◽

...

Keyword(s):

United States ◽

Patient Preferences ◽

Qualitative Data ◽

Immunoglobulin A ◽

The United States ◽

Small Sample ◽

Immunoglobulin A Nephropathy ◽

Sample Sizes ◽

Trade Offs ◽

The Us

IntroductionReimbursement agencies are increasingly using patient preference data to evaluate health technologies. Discrete choice experiments (DCE) are commonly used to elicit patient preferences, but they require large sample sizes to obtain meaningful results. For this reason, it is often not possible to use DCE to elicit patient preferences in rare diseases. This study assessed a swing weighting method for eliciting preferences from a small sample: patients with immunoglobulin A nephropathy (IgAN) in the United States (US) and China.MethodsAttributes and levels were selected based on a review of clinical studies and qualitative research on patients. Computer-assisted, interview-based swing weighting exercises were piloted in a focus group with five participants each from the US and China. Preferences were then elicited in interviews with twenty-five patients in the US and fifteen patients in China. Consistency tests were used to assess internal validity. Qualitative data were collected on the reasons for patients’ preferences.ResultsPreference consistency: The weights for one attribute were elicited twice. The difference between initial and consistency test weights was not statistically significant (p < 0.1), although this may partly reflect the small sample sizes. Trade-offs: Qualitative data were used to demonstrate the validity of interpreting participants’ ratings as trade-offs. Using the partial value function for end-stage renal disease as an example, qualitative data demonstrated that patients were able to provide face-valid reasons for different shaped, non-linear preference functions. Robustness of treatment evaluation: Three hypothetical treatment profiles (using the attribute swings) were constructed. Preferences for these treatment profiles were robust to variations in patients’ preferences; all patients preferred one specific profile. This finding was not sensitive to changes in weights.ConclusionsThis study supports the feasibility of collecting valid and robust preference data from small groups of patients using swing weighting. Further work could be done to test the performance of swing weighting in larger sample sizes.

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