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.
Acknowledgments
The authors would like to thank all of the patients who participated in the survey. They would also like to thank the physicians and (study) nurses for recruiting the patients, especially: PD Dr med. Heiko Golpon, Annette Nocon (Hannover Medical School: Department of Pneumology), Prof Dr med. Arndt Vogel and team (Hannover Medical School: Department of Gastroenterology, Hepatology and Endocrinology, Hannover, Germany), Dr med. Parvis Sadjadian (Johannes Wesling Medical Center, Department of Hematology, Oncology, Hemostaseology, and Palliative Care UKRUB, University of Bochum, Minden), Dr med. Monika Heilmann and Mrs J Brandes (Lung Cancer Center at the Hospital Region Hannover), Dr rer. nat. Silvia Wagner and Dr med. Silke Templin (Clinic for Visceral, General and Transplant Surgery Surgical Study Center, University Hospital Tuebingen), Dr med. Michael Gärtner and his team (Ambulatory Oncological Center Hannover), Dr med. Raack and Gabriele Germann (Group Practice for Internal Medicine and Pulmonology, Celle), PD Dr med. Annalen Bleckmann (Interdisciplinary Short-term Oncology, Department of Hematology and Medical Oncology, Goettingen), Dr med. Detlev Schröder and the study nurse Annette Gieseke (Group Practice for Hematology and Oncology, Hannover).
This study was supported by the Federal Ministry of Education and Research (grant number 01EH1201A).
Author contributions
All authors contributed toward data analysis, drafting and revising the paper and agree to be accountable for all aspects of the work.
Disclosure
The authors report no conflicts of interest in this work.