Patient Treatment Preferences Research Articles

Factors Influencing Patient Receptivity to Brief Alcohol Interventions in Primary Care: An Application of Conjoint Analysis

Background : Brief alcohol interventions (BAIs) are an evidence-based practice for addressing hazardous alcohol use in primary care settings. However, numerous barriers to implementation of BAIs in routine practice have been identified, including concerns about patient receptivity to BAIs. Despite this being a commonly identified barrier to BAI implementation, little BAI implementation research has focused on patient receptivity. Objectives : This study aimed to identify the treatment preferences of primary care patients who screened positive for hazardous alcohol use and to evaluate factors that may influence patients’ receptivity to BAIs delivered in primary care. We conducted a mailed survey of primary care patients (N = 245) who screened positive for hazardous alcohol use on annual screening measures based on electronic medical record data. Patients completed measures assessing treatment preferences and a conjoint analysis questionnaire designed to evaluate the relative importance of three factors (focus of the BAI, tailoring of the BAI, and familiarity with the provider delivering the BAI) for patient receptivity. Results : Conjoint analysis results revealed that familiarity with provider (with patients preferring BAIs delivered by providers they have previously met) was the most important factor in predicting patients’ receptivity to BAIs. Additionally, patients preferred to discuss alcohol use in the context of another concern (focus of the BAI) and preferred personalized information tailored based on their specific health concerns (tailoring of the BAI), although these factors were not statistically significant when accounting for familiarity with provider. Conclusions : Findings of the present study have potential to inform future research on implementation of BAIs.

Abstract P173: Impact Of Treatment Stage And Blood Pressure Severity On Preference For Drug And/or Device-based Treatments In Patients With Uncontrolled Hypertension

Background: Patient non-adherence to antihypertensive (AH) drugs impacts achieving treatment goals, highlighting the need for adjunctive therapies such as radiofrequency renal denervation (RDN). Patient preference for an intervention vs. drug therapy is poorly understood. We assessed patient treatment preferences at different stages of HTN management using a calculator derived from a discrete choice experiment (DCE) study. Methods: Preferences in 3 different clinical scenarios in the natural course of HTN management were evaluated: (1) initiating AH drugs vs. interventional treatment in untreated patients with mild-moderate HTN; (2) increasing drugs vs. interventional treatment with no drug change in patients with mild-moderate HTN; (3) increasing drugs vs. interventional treatment with no drug change in patients with severe resistant HTN. The predicted probability of choosing one treatment vs. the other was calculated based on preference-weighted treatment attributes (type of treatment, changes in AH drugs, BP reduction, effect duration, risk of drug side effects, intervention related adverse events). The values chosen for each scenario were derived from published RDN studies, the literature, and expert opinion. Results: Comparing scenario 1 to 2 to 3, the preference to select an intervention without drugs or change in drugs increased from 17% to 24% to 45%. Conversely, the preference to select either initiation or an increase in drugs decreased from 83% to 76% to 55%. The magnitude of BP reduction was the major driver of calculated patient preferences while drug and interventional treatment-related adverse events had a smaller impact on calculated patient preferences. Conclusions: Using preference-weights derived from a discrete choice experiment, a model predicting patient choice for drug vs. interventional treatment was applied to clinical scenarios derived from the natural course of management of patients with uncontrolled HTN. Preference for an interventional treatment increased from 17% in treatment naïve patients to 45% in patients with severe resistant HTN. Patient preference was driven predominantly by efficacy outcomes and minimally by safety concerns.

Real-world physician practices on the diagnosis and management of allergic rhinitis in the Philippine setting.

Physician awareness and adherence to guidelines varies among countries and between types of physician practice. Identifying the needs of the physician and patient is essential to improve patient outcome. Data on physician diagnosis and management of allergic rhinitis (AR) in the Philippines is currently limited. Study objectives are to assess awareness and use of guidelines, practices on diagnosis and management of intermittent and persistent AR, reasons for choice of therapy, and familiarity with immunotherapy. A cross-section of 590 specialist and 223 subspecialist physicians from 17 regions of the Philippines were surveyed from October 2021 to July 2022. Survey consisted of a 12-point validated online questionnaire on knowledge and use of guidelines for diagnosis and treatment, use of diagnostic tests, preferred pharmacologic treatment, preferred adjuvant therapy, reasons for treatment choice, and familiarity with immunotherapy. Seventy-seven percent of respondents used Allergic Rhinitis and its Impact on Asthma guidelines for diagnosis and management of AR. Three-fifths of respondents "always" routinely evaluated AR patients' history and performed a physical examination for asthma; 57% of respondents "always" routinely evaluated asthma patients' history and performed a physical examination for AR. Allergy testing was "sometimes" recommended by 62.2%. Oral second-generation antihistamines were the preferred choice for the treatment of intermittent AR. Intranasal steroids were the preferred treatment for persistent AR. Top reasons for choice of treatment were guideline recommendations, efficacy, onset of action, cost, and availability of treatment. Filipino specialists and subspecialists are aware and use guidelines in diagnosis and management of AR. Clinical history and physical examination are the cornerstone of diagnosis. Management practices for intermittent and persistent AR are similar for both groups. Recognizing the role of patient treatment preferences and allergen-specific immunotherapy remains to be a gap in the management of AR by Filipino physicians.

Treatment strategy changes for inflammatory bowel diseases in biologic era: results from a multicenter cohort in Japan, Far East 1000

Many molecular targeted agents, including biologics, have emerged for inflammatory bowel diseases (IBD), but their high prices have prevented their widespread use. This study aimed to reveal the changes in patient characteristics and the therapeutic strategies of IBD before and after the implementation of biologics in Japan, where the unique health insurance system allows patients with IBD and physicians to select drugs with minimum patient expenses. The analysis was performed using a prospective cohort, including IBD expert and nonexpert hospitals in Japan. In this study, patients were classified into two groups according to the year of diagnosis based on infliximab implementation as the prebiologic and biologic era groups. The characteristics of therapeutic strategies in both groups were evaluated using association analysis. This study analyzed 542 ulcerative colitis (UC) and 186 Crohn’s disease (CD). The biologic era included 53.3% of patients with UC and 76.2% with CD, respectively. The age of UC (33.9 years vs. 38.8 years, P < 0.001) or CD diagnosis (24.3 years vs. 31.9 years, P < 0.001) was significantly higher in the biologic era group. The association analysis of patients with multiple drug usage histories revealed that patients in the prebiologic era group selected anti-tumor necrosis factor (TNF)-α agents, whereas those in the biologic era group preferred biologic agents with different mechanisms other than anti-TNF-α. In conclusion, this study demonstrated that both patient characteristics and treatment preferences in IBD have changed before and after biologic implementation.

Selecting an appropriate all-oral short-course regimen for patients with multidrug-resistant or pre-extensive drug-resistant tuberculosis in China: A multicenter prospective cohort study

ObjectivesLong, ineffective, and toxic regimens hinder the treatment of patients with multidrug-resistant tuberculosis (MDR-TB) and pre-extensive drug-resistant tuberculosis (pre-XDR-TB). MethodsWe conducted a multicenter cohort study to prospectively evaluate the safety and efficacy of three 9-month, all-oral, 5-drug regimens. Regimen A (bedaquiline [Bdq]+linezolid [Lzd]+moxifloxacin [Mfx]+cycloserine [Cs]+pyrazinamide [Pza]) and Regimen B (Lzd+Mfx+Cs+clofazimine [Cfz]+Pza) were used to treat MDR-TB patients (Groups A and B, respectively, assigned according to the patient's treatment preference), while Regimen C (Bdq+Lzd+Cs+Cfz+Pza) was used to treat pre-XDR-TB patients (Group C). The primary endpoint was the occurrence of an unfavorable outcome within 12 months of treatment completion, regardless of regimen. ResultsA total of 104 patients (34 in Group A, 46 in Group B, and 24 in Group C), with a median age of 35.5 (29.0-54.0) years, were included in the analysis population. At 12 months after treatment completion, five patients were deemed non-assessable. Of the remaining 99 participants, seven (7.1%) had an unfavorable outcome (including two deaths from any cause, four with treatment failure, and one loss to follow-up) and 92 (92.9%) had a favorable outcome. Culture conversion was achieved in 82.5% (80/97) of participants at month 2 and in 97.9% (94/97) of participants at month 6. Adverse events (AEs) resulting in drug adjustment occurred in 69.2% (72/104) of participants, mainly due to Lzd and Pza use. A QT interval prolongation of ≥ 500 ms occurred in 5.8% (6/104) of participants. ConclusionThe primary outcome of the three tailored, 9-month, all-oral, 5-drug regimens was satisfactory in the vast majority of MDR-TB and pre-XDR-TB patients, with manageable and reversible AEs.

The Effects of Patient Characteristics on the Management of Subclinical Hypothyroidism: A Survey of Faculty and Trainees

ObjectiveThere is no universal approach to the management of subclinical hypothyroidism (SCH). This study was designed to determine the impact of patient characteristics on management decisions in SCH amongst physician faculty members and trainees. MethodsAn online survey was distributed to faculty members and medical trainees (ie, interns, residents, and fellows) at multiple academic medical centers. The survey included 9 clinical scenarios describing women with SCH with 5 management options sequenced from most “conservative” (no further treatment or monitoring) to most “aggressive” (treatment with levothyroxine). ResultsOf the 194 survey respondents, 95 (49.0%) were faculty members and 99 (51.0%) were trainees. Faculty members were more likely to report being “confident” or “very confident” in making the diagnosis of SCH compared to trainees (95.8% vs 46.5%, P < .001). Faculty members were also more likely to consider patient preference for treatment (60.0% vs 32.3%, P < .001). Among all respondents, the clinical factors that resulted in the highest predicted probability of treatment were hypothyroid symptoms (predicted probability [PP] 68.8%, 95% CI [65.7%-71.9%]), thyroid stimulating hormone >10 mIU/L in a 31-year-old (PP 63.9%, 95% CI [60.3%-67.3%]), and the desire for fertility (PP 52.2%, 95% CI [48.6%-56.0%]). In general, faculty members favored more aggressive treatment across all clinical scenarios. ConclusionThe presence of symptoms, thyroid stimulating hormone >10 mIU/L, and desire for fertility were most predictive of the decision to treat in SCH. In several clinical scenarios, both trainee and faculty decision-making demonstrated discordance with general SCH management principles.

Patient Experiences After Aborted Cancer Surgery: A Qualitative Study.

Surgical resection is a necessary component of curative-intent treatment for most solid-organ cancers but is occasionally aborted, most often due to occult metastatic disease or unanticipated unresectability. Despite its frequency, little research has been performed on the experiences, care needs, and treatment preferences of patients who experience an aborted cancer surgery. Semistructured interviews of patients who had previously experienced an aborted cancer surgery were conducted, focusing on their recalled experiences and stated preferences. All interviews were audio recorded, transcribed, and coded by two independent researchers by using NVivo 12. An integrative approach to qualitative analysis was used-both inductive and deductive methods-and iteratively identifying themes until saturation was reached. Fifteen patients with an aborted cancer surgery participated in the interviews. Cancer types included pancreatic (n = 9), cholangiocarcinoma (n = 3), hepatocellular carcinoma (n = 1), gallbladder (n = 1), and neuroendocrine (n = 1). The most common reasons for aborting surgery included local tumor unresectability (n = 8) and occult metastatic disease (n = 7). Five subthemes that characterized the patient experience following an aborted cancer surgery emerged, including physical symptoms, emotional responses, impact on social and life factors, coping mechanisms, and support received. This qualitative study characterizes the impact of aborted cancer surgery on multiple domains of quality of life: physical, emotional, social, and existential. These results highlight the importance of developing patient-centered interventions that focus on enhancing quality of life after aborted cancer surgery.

Treatment preference and quality of life impact: ravulizumab vs eculizumab for atypical hemolytic uremic syndrome.

Aim: Ravulizumab and eculizumab are complement C5 inhibitors approved for the treatment of atypical hemolytic uremic syndrome (aHUS). Ravulizumab requires less frequent infusions than eculizumab, which may reduce treatment burden. This study investigated patients' treatment preferences and the impact of both treatments on patient and caregiver quality of life. Materials & methods: Two surveys were conducted (one for adult patients with aHUS and one for caregivers of pediatric patients with aHUS) to quantitatively assess treatment preference and the patient- and caregiver-reported impact of ravulizumab and eculizumab on quality of life. Patients were required to have a diagnosis of aHUS, to be currently receiving treatment with ravulizumab and to have received prior treatment with eculizumab. Participants were recruited via various sources: the Alexion OneSource™ patient support program, the Rare Patient Voice recruitment agency, the aHUS Foundation and directly via a clinician involved in the study. Results: In total, 50 adult patients (mean age: 46.5years) and 16 caregivers of pediatric patients (mean age: 10.1years) completed the surveys. Most adult patients (94.0%) and all caregivers reported an overall preference for ravulizumab over eculizumab; infusion frequency was one of the main factors for patients when selecting their preferred treatment. Fewer patients reported disruption to daily life and the ability to go to work/school due to ravulizumab infusion frequency (4.0% and 5.7%, respectively) than eculizumab infusion frequency (72.0% and 60.0%), with similar results for caregivers. Conclusion: Adult patients and caregivers of pediatric patients indicated an overall preference for ravulizumab than eculizumab for the treatment of aHUS, driven primarily by infusion frequency. This study contributes to the emerging real-world evidence on the treatment impact and preference in patients with aHUS.

Preference of acromegaly patients for treatment attributes in Spain.

Acromegaly is a rare disease caused by increased growth hormone secretion and a subsequent increase in insulin-like growth factor I (IGF-I) levels. Patients display multiple comorbidities that affect their quality of life (QoL). Treatment aims to maintain good biochemical control, tumour control and reduce the risk of comorbidities; however, their impact on QoL has been overlooked until recently. We interviewed patients to explore their preferences with regard to treatment attributes. A cross-sectional study based on interviews and a discrete choice experiment (DCE) in a Spanish cohort. Adult patients diagnosed with acromegaly ≥1 year before the start of the study and under treatment were included. Treatment attributes were collected from patient testimony during face-to-face interviews. Then, a DCE was performed to elicit patient preferences for certain treatment attributes. Sixty-seven patients completed the study. QoL improvement was the most important treatment attribute (37%), followed by IGF-I control (20%), blood sugar control (17%) and tumour control (13%). Secondary attributes were pain associated with the route of administration (7%), diarrhoea (2%), administration method (2%) and storage conditions (2%). We then calculated the theoretical share of preference for existing treatments, based on the individual preference utility for each attribute and level. Pegvisomant obtained the highest share of preference overall, and the highest preference as a second-line treatment (53 and 95%, respectively). QoL greatly influences patient treatment preference. Since acromegaly patients are informed and aware of their disease, treatment choices should always be shared with patients.

Physical function and severe side effects matter most to patients with RA (< 5 years): a discrete choice experiment assessing preferences for personalized RA treatment

AimEarly assessment of patient preferences has the potential to support shared decisions in personalized precision medicine for patients with rheumatoid arthritis (RA). The aim of this study was to assess treatment preferences of patients with RA (< 5 years) with previous experience of inadequate response to first-line monotherapy.MethodPatients were recruited (March–June 2021) via four clinics in Sweden. Potential respondents (N = 933) received an invitation to answer a digital survey. The survey included an introductory part, a discrete choice experiment (DCE) and demographic questions. Each respondent answered 11 hypothetical choice questions as part of the DCE. Patient preferences and preference heterogeneity were estimated using random parameter logit models and latent class analysis models.ResultsPatients (n = 182) assessed the most important treatment attributes out of physical functional capacity, psychosocial functional capacity, frequency of mild side effects and likelihood of severe side effects. In general, patients preferred a greater increase in functional capacity and decreased side effects. However, a substantial preference heterogeneity was identified with two underlying preference patterns. The most important attribute in the first pattern was the ‘likelihood of getting a severe side effect’. Physical functional capacity was the most important attribute in the second pattern.ConclusionRespondents focused their decision-making mainly on increasing their physical functional capacity or decreasing the likelihood of getting a severe side effect. These results are highly relevant from a clinical perspective to strengthen communication in shared decision making by assessing patients’ individual preferences for benefits and risks in treatment discussions.

Preference of musculoskeletal pain treatment in middle-aged and elderly chinese people: a machine learning analysis of the China health and retirement longitudinal study

BackgroundMusculoskeletal pain is a major cause of physical disability, associated with huge socioeconomic burden. Patient preference for treatment is an important factor contributing to the choice of treatment strategies. However, effective measurements for evaluating the ongoing management of musculoskeletal pain are lacking. To help improve clinical decision making, it’s important to estimate the current state of musculoskeletal pain management and analyze the contribution of patient treatment preference.MethodsA nationally representative sample for the Chinese population was derived from the China Health and Retirement Longitudinal Study (CHARLS). Information on the patients’ demographic characteristics, socioeconomic status, other health-related behavior, as well as history on musculoskeletal pain and treatment data were obtained. The data was used to estimate the status of musculoskeletal pain treatment in China in the year 2018. Univariate analysis and multivariate analysis were used to find the effect factors of treatment preference. XGBoost model and Shapley Additive exPlanations (SHAP) method were performed to analyze the contribution of each variable to different treatment preferences.ResultsAmong 18,814 respondents, 10,346 respondents suffered from musculoskeletal pain. Approximately 50% of musculoskeletal pain patients preferred modern medicine, while about 20% chose traditional Chinese medicine and another 15% chose acupuncture or massage therapy. Differing preferences for musculoskeletal pain treatment was related to the respondents’ gender, age, place of residence, education level, insurance status, and health-related behavior such as smoking and drinking. Compared with upper or lower limb pain, neck pain and lower back pain were more likely to make respondents choose massage therapy (P < 0.05). A greater number of pain sites was associated with an increasing preference for respondents to seek medical care for musculoskeletal pain (P < 0.05), while different pain sites did not affect treatment preference.ConclusionFactors including gender, age, socioeconomic status, and health-related behavior may have potential effects on people’ s choice of treatment for musculoskeletal pain. The information derived from this study may be useful for helping to inform clinical decisions for orthopedic surgeons when devising treatment strategies for musculoskeletal pain.

405 Understanding patient experience and factors influencing patient preference in the treatment of moderate-to-severe atopic dermatitis through in-depth qualitative patient interviews

Abstract Atopic dermatitis (AD) can enormously affect the lives of patients and their caregivers. Treatments for moderate-to-severe AD include phototherapy, topical and systemic corticosteroids, other immunosuppressive agents and biologic therapies. These treatments offer varied levels of efficacy, safety, response times and modes of administration. Patient preferences for these treatment options and attributes influencing their treatment choice are not well characterized. This qualitative interview-based study evaluated treatment attributes important to adult patients with moderate-to-severe AD providing a basis for a future quantitative discrete choice experiment (DCE). Semi-structured interviews were conducted in adults (≥18 years) recruited via a panel of geographically and demographically diverse patients with AD in the USA. Inclusion required (i) diagnosis of AD for at least one year, (ii) inadequate response to prior topical therapy and (iii) self-reported moderate-to-severe AD or experience with systemic therapy. One-on-one, in-depth 60-min phone interviews were conducted by a trained interviewer in AD real-word evidence studies. Subjects with experience with systemic therapy for AD were queried concerning their involvement in initiating, logistics of and general experience with their most recent systemic treatment. Finally, participants were asked to rate the importance (on a 1–5 scale with 5 being the most important) of 17 attributes that could play a role in their treatment decision-making; these attributes were identified from a targeted literature review and expert dermatologist clinical input. Attributes included treatment efficacy, adverse events and treatment logistics. Interviews are ongoing, and results will be ready and presented in the poster upon acceptance. Findings from the interviews will shed light on recent patient experience with treatments for moderate-to-severe AD and elucidate the treatment attributes that most impact patient treatment preferences. These results will guide the design of a subsequent DCE survey, which will help quantify the relative importance of the treatment attributes identified herein.

The clinical profile of individuals with symptoms of knee osteoarthritis referred to secondary care in Denmark: Across-sectional study of 282 people.

The clinical profile of individuals with symptoms of knee osteoarthritis referred to secondary care in Denmark: Across-sectional study of 282 people.

Male patients’ preferences for opioid use treatment programs

BackgroundA patient-centered approach to the treatment of substance use is helpful in achieving positive treatment outcomes. This study aimed to explore male patients’ preferences for opioid use treatments.MethodsA qualitative study was conducted in Isfahan, a city in the center of Iran. The study sample included 64 male participants who had started treatment for opioid use disorder (OUD). Using a purposive maximum variation sampling procedure, seven treatment centers were selected as interview venues. The semi-structured face-to-face interviews were conducted in a private room in the selected centers. A hybrid inductive/deductive approach was used to thematize the interview transcripts.ResultsA total of three themes and 13 subthemes on opioid treatment preferences were identified: treatment concerns (anonymity, social stigma, fear of treatment distress, and family concerns), treatment attributes (treatment cost, location of the treatment center, treatment period, frequency of attendance, informed treatment, and treatment personnel), and treatment type (maintenance or abstinence and residential and community treatments). The study showed that all treatment programs were perceived to have their own strengths and weaknesses.ConclusionsThe results showed that patients with OUD carefully compare the positive and negative aspects of existing treatment programs, and they consider a treatment program to be a package of favorable and non-favorable qualities. The identified themes could inform policymakers about the treatment preferences of male patients and provide an opportunity to promote better treatment options for OUD.

Interdisciplinary pain rehabilitation and sexual functioning: Treatment outcomes and patient preferences.

Sexual dysfunction is common for patients experiencing chronic pain. Prior research is limited on how treatment for chronic pain affects patients' sexual functioning. This study reports pre-/post-treatment measures of self-reported sexual functioning among individuals presenting for chronic pain treatment at an interdisciplinary pain rehabilitation program (IPRP) and reports patient treatment preferences. This study uses detailed treatment measures across multiple domains of sexual functioning to describe the prevalence and correlates of self-reported sexual functioning among individuals with chronic pain presenting for and discharging from treatment at an IPRP (N = 71). Domains include sexual interest, satisfaction with sexual functioning, vaginal lubrication, vaginal discomfort, and erectile function. Patients also completed a multiple-choice treatment preferences questionnaire created for this study. Results from this study show a high prevalence of sexual dysfunction in chronic pain populations (51.5%) and show no significant difference in sexual functioning after completing outpatient treatment, except for a significant improvement in sexual satisfaction for males only. Results from the patient treatment preferences questionnaire indicate that most patients (83.3%) thought their pain was important to address within the context of an IPRP; however, many patients (58.7%) did not think their treatment addressed sexual functioning. In addition, many patients (34%) would prefer to discuss sexual functioning with their primary care provider or pelvic floor physical therapist. Findings demonstrate that usual multidisciplinary pain management treatment is not sufficient to address patients' concerns with sexual functioning. Additional creative strategies will need to be studied on how to best treat these overlapping problems. Implications and future research directions are discussed.

The impact of surgery on patients with VHL-associated tumors: An international patient survey.

4517 Background: Von Hippel-Lindau syndrome (VHL) is a rare hereditary neoplastic disorder caused by mutations in the VHL gene. Treatment (tx) options for patients are limited to multiple surgeries dispersed between regular scans, watchful waiting and txs that preserve organ function. Methods: An international, cross-sectional survey comprising patients in the United States (US), Canada (CA), the United Kingdom (UK), France (FR), and Germany (DE) was conducted. Patients were recruited via the VHL Alliance; data were collected between Dec 2021 and May 2022. For inclusion, patients must have renal cell carcinoma (RCC), pancreatic neuroendocrine tumors (pNET), and/or central nervous system hemangioblastoma (CNS-Hb). Data collected included demographics, impact of most recent surgery on aspects of condition (1-7 scale 1 being greatly worsened and 7 being greatly improved), tx goals (top 3 goals from a list of 11), and patient preference in treatment. Patients were presented two scenarios “watch and wait” and potentially need surgery, or “take a once-daily pill” to delay a potential surgery. Results: 220 patients (68.2% female, median age 40.0, median disease duration 15.8 years) in the US (n=108), CA (n=37), the UK (n=21), FR (n=3), and DE (n=51) completed the study. 146 patients reported RCC (66.4%), n=122 reported pNET (55.5%), and n=190 reported CNS-Hb (86.4%). Among the top 4 symptoms experienced by patients were kidney cysts (n=82, 37.3%), numbness (n=59, 26.8%), dizziness (n=56, 25.5%), and fatigue/low energy (n=54, 24.5%). 205 (93.2%) patients had experienced surgery; n=171 (77.7%) had experienced multiple surgeries (median number of surgeries, 4.0). 166 patients recorded data on their most recent surgery. Of these, patients reported that their most recent surgery worsened (scored 1-3) their fatigue (51.8%), mental health (51.2%), and ability to go about daily life (45.2%). 47.3% of patients selected reduce the number of surgeries as a top tx goal, 46.4% selected being able to go about life as usual, 36.8% delay the need for surgery, and 33.2% improved quality of life. 73% of patients indicated they would prefer to take a pill which would possibly delay the time until surgery, rather than watch and wait to see if the tumor would grow. Conclusions: Surgery negatively impacts the lives of patients, leading to a worsening in their fatigue, mental health, and ability to go about daily life. Almost half of patients would like a treatment that reduces the number of surgeries, and over a third would like a treatment that delays the need for surgery. Nearly three quarters of patients would prefer to take a pill that might delay the need for surgery. Tx options that reduce the need for surgery would benefit this patient group.

PCR86 Using Qualitative Methods to Develop Grounded Relevant Content for Preference Surveys in a Specific Rare Bleeding Disorder (SRBD)

Literature attributing the factors to patient and Health Care Professional (HCP) treatment preferences in a specific rare bleeding disorder (sRBD) is lacking. This study (i) explores qualitatively with key medical experts the relevance of existing factors published in the literature attributing to sRBD (ii) identifies any other factors that pertain specifically to the rare bleeding disorder and (iii) aims to inform the development of a patient and HCP preference survey.

HSD5 Patient and Caregiver Spinal Muscular Atrophy (SMA) Treatment Attribute Preferences in Latin America

As access to spinal muscular atrophy (SMA) disease-modifying therapies widens, it is important to understand patient and caregiver treatment preferences. This study aims to identify which treatment attributes drive treatment choices in adult patients and caregivers of patients with SMA across Latin America.

Treatment preferences among patients with mild-to-moderate atopic dermatitis

Study purpose: New treatments for atopic dermatitis (AD) are emerging; however, little is known about the treatment preferences of patients with mild-to-moderate AD. To measure patients’ preferences, a cross-sectional, web-based discrete choice experiment (DCE) survey was developed and administered to 300 adults in the United States with a self-reported physician diagnosis of mild-to-moderate AD.Materials and methods: In the DCE, respondents evaluated pairs of hypothetical AD treatment profiles defined by efficacy, risk, and mode and frequency of administration attributes. The DCE data were analyzed using a random parameters logit model. Subgroup analysis was used to investigate preference heterogeneity.Results: The results revealed achieving clear or almost clear skin within 3-4 months of treatment was the most important attribute relative to all other study attributes. The results indicated that a topical cream applied twice daily was preferred to systemic treatments. Subgroup analysis revealed that respondents with lower self-assessed disease burden were more likely to choose topical over systemic treatments and less averse to the risk of pain, burning, and/or stinging from the medicine (all other treatment features remaining equal) than respondents with higher self-assessed disease burden.Conclusion: The results of this study can help inform shared decision-making to manage mild-to-moderate AD.

Treatment preferences of patients with esophageal cancer

Zusammenfassung Hintergrund Die Behandlung von Ösophaguskarzinom nach geltendem Standard ist eine Operation, die nach einer neoadjuvanten Chemotherapie (nCT) oder Radiochemotherapie (nCRT) erfolgt. Für Patient*innen mit klinischer Komplettresponse auf eine nCT/nCRT kann eine aktive Überwachung mit einer Operation nur bei Bedarf eine gleichwertige Option in Bezug auf das Überleben darstellen. Fragestellung Identifikation von Faktoren, die Therapiepräferenzen, Beweggründe zur Entscheidungsfindung sowie Befürchtungen/Hoffnungen von EC-Patient*innen hinsichtlich der Wahl der beiden Behandlungsoptionen. Material und Methode Die qualitative Erhebung mit teilstrukturierten Einzelinterviews mit EC-Patient*innen und Expert*inneninterviews mit Ärzt*innen, Pflegekräften und Psychoonkolog*innen. Ergebnisse Die ärztliche Aufklärung stellt bei der Therapiepräferenz eine Entscheidungsgrundlage dar. Hierbei wird nicht nur eine empathische und kompetente Beratung, sondern auch eine konkrete Anweisung bzgl. der Therapiewahl von den behandelnden Ärzt*innen erwartet. Als ein wesentlicher Faktor für die Therapiewahl wird das Alter genannt. Vor allem erhöhtes Komplikationsrisiko während oder nach einer Operation bzw. körperliche Schwäche scheinen für Patient*innen in höherem Alter ein bedeutsamer Grund zu sein, eine Operation nach Bedarf zu bevorzugen. Die Entscheidung für oder gegen eine bestimmte Therapie orientiert sich an Lebenszeit und Lebensqualität der Patient*innen, die immer individuell und unterschiedlich interpretiert wird. Schlussfolgerungen Nach den hier vorliegenden qualitativen Daten ist die sofortige Operation die primäre Behandlungsoption bei Patient*innen mit Ösophaguskarzinom (7 von 11), dennoch sehen einige Patient*innen sehr wohl die Vorteile der alternativen Behandlungsmethode und würden eine Operation nach Bedarf bevorzugen. Die überwiegende Anzahl der Patient*innen (8 von 11) würde an einer RCT teilnehmen und betrachtet die Teilnahme als eine einmalige Chance, eine alternative Behandlungsmethode zu erhalten, eine Operation zu vermeiden und somit ihre Lebensqualität zu verbessern.