Understanding treatment decisions for Hodgkin lymphoma: a qualitative study

Abstract

Hodgkin lymphoma (HL) affects older and younger patients and includes multiple options for initial treatment. We sought to examine the decision processes of practicing oncologists caring for patients with newly diagnosed HL. Through semi-structured interviews, we explored their perspectives about treatment decisions. We completed thematic analysis using the Anderson Behavioral Model of Health Services framework to identify factors associated with initial decisions. We completed 22 interviews, grouping findings into contextual factors, individual characteristics, and physician preferences. Paternalism was widely cited, along with collaboration between community and academic colleagues. Participants used sequential therapy but not geriatric assessment in care for older patients. Physicians had varied responses about use of frontline brentuximab vedotin (Bv)-based therapy based on perceptions about benefit versus toxicity. Our work suggests a need to further understand the heterogeneity of clinical practices, especially in the post-approval setting of new therapies.

Keywords:

• Lymphoma and Hodgkin disease
• neoplasia
• qualitative research
• cancer care delivery

Disclosure statement

SKP has received consulting fees from SEattle Genetics.

Additional information

Funding

This work was supported by the Lymphoma Research Foundation Career Development Award (AJK) and by the National Center for Advancing Translational Sciences, National Institutes of Health, Award Number UL1TR002546 (AJK) and the National Institutes of Health, Award Number K12HD092535 (AL). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.