P1.16-21 Does Age Affect What Patients Value When Considering Lung Cancer Treatments? Evidence from a National Survey

Abstract

Few studies have explored how values vary with patients’ lung cancer treatment experience. Due to the rapidly increasing number of treatments for lung cancer, we sought to demonstrate a simple values-elicitation method and explore how values differ across age. The values of patients and caregivers with small cell (SCLC) and non-small cell lung cancer (NSCLC) inclusive of all stages were explored using a simple values elicitation exercise developed in partnership with diverse stakeholder advisory boards. Respondents were presented with five treatment characteristics, including progression free survival (PFS), short-term side effects (ST-SE), long-term side effects (LT-SE), and mode of administration. All characteristics and plausible outcomes were described. Values were elicited using a simple three-point Likert scale spanning not important, somewhat important, and very important, which were scored as 0, 5, and 10 respectively. Data came from a national survey completed in partnership with LUNGevity and other partners. Differences in values were explored between patients and caregivers, as well as across patients’ self-reported age with two sample t-tests. Among 793 eligible respondents, 556 were patients (70%) with 77% NSCLC, 11% SCLC, 12% unknown subtype and 233 were caregivers (30%). The average patient age was 58.4 years (y) (SD = 12.3), with 235 (42%) <60y and 321 (58%) ≥60y. PFS was the most important attribute for respondents, but was undervalued by caregivers compared to patients (mean score (MS): 8.1 v 8.6, P = 0.014). Caregivers overvalued the importance of ST-SE (MS: 7.0 v 6.1, P <0.001), LT-SE (MS: 8.4 v 7.6, P = 0.001), and mode of administration (MS: 6.9 v 6.1, P = 0.006). PFS was the most important attribute and valued similarly among younger vs. older patients (MS: 8.7 v 8.6, P = 0.76). However, ST-SE (MS: 6.4 v 5.8, P = 0.042) and LT-SE (MS: 8.0 v 7.4, P = 0.018) were more important among patients <60y vs. ≥60y, respectively. Among patients with lung cancer, progression free survival was highly valued regardless of patient age. Older patients value short term and long term side effects differently as compared to younger patients.