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Supportive Care in Cancer

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01-04-2018 | Original Article

A discrete choice experiment to assess cancer patients’ preferences for when and how to make treatment decisions

Authors: Anne Herrmann, Rob Sanson-Fisher, Alix Hall, Laura Wall, Nicholas Zdenkowski, Amy Waller

Published in: Supportive Care in Cancer | Issue 4/2018

Abstract

Purpose

Cancer patients can be overwhelmed when being confronted with their diagnosis and treatment options. Such information is often provided during one consultation between the patient and treating clinician. In order to achieve optimal cancer care, there may be justification for alternative consultation styles. We assessed, in a sample of adult medical oncology patients, their preferences for (i) attending one 40-min consultation or two 20-min consultations and (ii) receiving written only or both written and online information, when making a cancer treatment decision.

Methods

This was a cross-sectional survey using a discrete choice design of 159 adult medical oncology patients presenting for their second or subsequent outpatient consultation. Participants were presented with a set of hypothetical scenarios and asked to indicate their most and least preferred scenario. The scenarios contained a caveat explaining that there would be no difference between the available treatment options in terms of when treatment would be initiated and the impact it would have on patients’ life expectancy.

Results

One hundred forty-seven patients completed the DCE. Of these, 70% (n = 103) preferred being provided with written and online information rather than just written information. This preference was statistically significant (p < 0.01). Fifty-nine percent (n = 86) of patients preferred two 20-min consultations over one 40-min consultation when making a treatment decision. Significantly, more patients preferred two shorter consultations rather than one longer consultation when this was combined with written and online information (p < 0.01).

Conclusion

When making a cancer treatment decision, clinicians should consider offering patients written and online information, combined with two shorter consultations.

Institute of Medicine (2001) Crossing the quality chasm: a new health system for the 21st century committee on quality of health care in America, Washington, DC

Katz SJ, Belkora J, Elwyn G (2014) Shared decision making for treatment of cancer: challenges and opportunities. J Oncol Pract 10(3):206–208. https://doi.org/10.1200/JOP.2014.001434 CrossRefPubMedPubMedCentral

Pettingale KW, Burgess C, Greer S (1988) Psychological response to cancer diagnosis—I. Correlations with prognostic variables. J Psychosom Res 32(3):255–261. https://doi.org/10.1016/0022-3999(88)90066-9 CrossRefPubMed

General Medical Council (2008) Consent: patients and doctors making decisions together. General Medical Council, Manchester

Girgis A, Sanson-Fisher RW (1995) Breaking bad news: consensus guidelines for medical practitioners. J Clin Oncol 13(9):2449–2456CrossRefPubMed

Butow PN, Dunn SM, Tattersall MH, Jones QJ (1995) Computer-based interaction analysis of the cancer consultation. Br J Cancer 71(5):1115–1121CrossRefPubMedPubMedCentral

Butow P, Devine R, Boyer M, Pendlebury S, Jackson M, Tattersall MHN (2004) Cancer consultation preparation package: changing patients but not physicians is not enough. J Clin Oncol 22(21):4401–4409. https://doi.org/10.1200/jco.2004.66.155 CrossRefPubMed

Ryan M (2004) Discrete choice experiments in health care. BMJ 328(7436):360–361CrossRefPubMedPubMedCentral

Louviere JJ (2001) Choice experiments: an overview of concepts and issues. The choice modelling approach to environmental valuation. In: Bennett J, Blamey R (eds) The choice modelling approach to environmental valuation. Edward Elgar Publishing, Cheltenham, pp 13–36

10.

Lancsar E, Louviere J (2008) Conducting discrete choice experiments to inform healthcare decision making. PharmacoEconomics 26(8):661–677. https://doi.org/10.2165/00019053-200826080-00004 CrossRefPubMed

11.

Jones LG, Hawkins GE, Brown SD (2015) Using best–worst scaling to improve psychological service delivery: an innovative tool for psychologists in organized care settings. Psychol Serv 12(1):20–27. https://doi.org/10.1037/ser0000011 CrossRefPubMed

12.

Politi MC, Street RL Jr (2011) The importance of communication in collaborative decision making: facilitating shared mind and the management of uncertainty. J Eval Clin Pract 17(4):579–584. https://doi.org/10.1111/j.1365-2753.2010.01549.x CrossRefPubMed

13.

Schofield PE, Butow PN, Thompson JF, Tattersall MHN, Beeney LJ, Dunn SM (2003) Psychological responses of patients receiving a diagnosis of cancer. Ann Oncol 14(1):48–56. https://doi.org/10.1093/annonc/mdg010 CrossRefPubMed

14.

van Weert JCM, van Noort G, Bol N, van Dijk L, Tates K, Jansen J (2011) Tailored information for cancer patients on the internet: effects of visual cues and language complexity on information recall and satisfaction. Patient Educ Couns 84(3):368–378. https://doi.org/10.1016/j.pec.2011.04.006 CrossRefPubMed

15.

Barry MJ, Edgman-Levitan S (2012) Shared decision making—the pinnacle of patient-centered care. N Engl J Med 366(9):780–781. https://doi.org/10.1056/NEJMp1109283 CrossRefPubMed

16.

Butow PN, Maclean M, Dunn SM, Tattersall MHN, Boyer MJ (1997) The dynamics of change: cancer patients’ preferences for information, involvement and support. Ann Oncol 8(9):857–863. https://doi.org/10.1023/A:1008284006045 CrossRefPubMed

17.

Coulter A, Peto V, Doll H (1994) Patients’ preferences and general practitioners’ decisions in the treatment of menstrual disorders. Fam Pract 11(1):67–74CrossRefPubMed

18.

Schubart JR, Toran L, Whitehead M, Levi BH, Green MJ (2013) Informed decision making in advance care planning: concordance of patient self-reported diagnosis with physician diagnosis. Support Care Cancer 21(2):637–641. https://doi.org/10.1007/s00520-012-1654-x CrossRefPubMed

19.

Bruera E, Sweeney C, Calder K, Palmer L, Benisch-Tolley S (2001) Patient preferences versus physician perceptions of treatment decisions in cancer care. J Clin Oncol 19(11):2883–2885. https://doi.org/10.1200/jco.2001.19.11.2883 CrossRefPubMed

20.

Zucca A, Sanson-Fisher R, Waller A, Carey M, Boadle D (2017) The first step in ensuring patient-centred quality of care: ask the patient. Eur J Cancer Care 26 (1):e12435-n/a. doi:https://doi.org/10.1111/ecc.12435

21.

Sabesan S, Larkins S, Evans R, Varma S, Andrews A, Beuttner P, Brennan S, Young M (2012) Telemedicine for rural cancer care in North Queensland: bringing cancer care home. Aust J Rural Health 20(5):259–264. https://doi.org/10.1111/j.1440-1584.2012.01299.x CrossRefPubMed

22.

Thaker DA, Monypenny R, Olver I, Sabesan S (2013) Cost savings from a telemedicine model of care in northern Queensland, Australia. Med J Aust 199(6):414–417CrossRefPubMed

23.

Légaré F, Ratté S, Gravel K, Graham ID (2008) Barriers and facilitators to implementing shared decision-making in clinical practice: update of a systematic review of health professionals’ perceptions. Patient Educ Couns 73(3):526–535. https://doi.org/10.1016/j.pec.2008.07.018 CrossRefPubMed

24.

Say RE, Thomson R (2003) The importance of patient preferences in treatment decisions—challenges for doctors. BMJ 327(7414):542–545. https://doi.org/10.1136/bmj.327.7414.542 CrossRefPubMedPubMedCentral

25.

Shay LA, Lafata JE (2015) Where is the evidence? A systematic review of shared decision making and patient outcomes. Med Decis Mak 35(1):114–131. https://doi.org/10.1177/0272989X14551638 CrossRef

26.

Gross SE, Nitzsche A, Gloede TD, Ansmann L, Street R, Pfaff H, Neumann M, Wirtz M, Baumann W, Schmitz S, Ernstmann N (2015) The initial clinical interview—can it reduce cancer patients’ fear? Support Care Cancer 23(4):977–984. https://doi.org/10.1007/s00520-014-2450-6 CrossRefPubMed

27.

Mark TL, Swait J (2004) Using stated preference and revealed preference modeling to evaluate prescribing decisions. Health Econ 13(6):563–573. https://doi.org/10.1002/hec.845 CrossRefPubMed

28.

Linley WG, Hughes DA (2013) Decision-makers’ preferences for approving new medicines in Wales: a discrete-choice experiment with assessment of external validity. PharmacoEconomics 31(4):345–355. https://doi.org/10.1007/s40273-013-0030-0 CrossRefPubMed

29.

de Bekker-Grob EW, Ryan M, Gerard K (2012) Discrete choice experiments in health economics: a review of the literature. Health Econ 21(2):145–172CrossRefPubMed

30.

Telser H, Zweifel P (2007) Validity of discrete-choice experiments evidence for health risk reduction. Applied Econ 39(1):69–78CrossRef

31.

Kiesler DJ, Auerbach SM (2006) Optimal matches of patient preferences for information, decision-making and interpersonal behavior: evidence, models and interventions. Patient Educ Couns 61(3):319–341. https://doi.org/10.1016/j.pec.2005.08.002 CrossRefPubMed

Title: A discrete choice experiment to assess cancer patients’ preferences for when and how to make treatment decisions
Authors: Anne Herrmann
Rob Sanson-Fisher
Alix Hall
Laura Wall
Nicholas Zdenkowski
Amy Waller
Publication date: 01-04-2018
Publisher: Springer Berlin Heidelberg
Published in: Supportive Care in Cancer / Issue 4/2018
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-017-3944-9

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Abstract

Purpose

Methods

Results

Conclusion

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