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 the 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 the current provision of cancer care by identifying areas of preferred intervention from the perspectives of patients in order to tailor the service supply accordingly.

Keywords:

• Patient satisfaction
• chemotherapy
• discrete choice experiment
• patient preferences

Transparency

Declaration of funding

The study and the development of this manuscript received no financial support.

Declaration of financial/other relationships

None of the authors have any significant relationships with, or financial interests in, any commercial companies related to this study or article. The authors have indicated that they have no conflicts of interest with regard to the content of this article. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

RR and EP planned and designed the study and drafted the manuscript. RR and DDC collected data and performed data analysis. PR, GR, LF, and SB assisted with the study design, data collection and writing the manuscript. All the authors discussed the results and read and approved the final manuscript.

Acknowledgements

The authors are grateful to Laura Fiorini and Laura Davico for their valuable help in administering the questionnaires and DCEs to patients.