Patient Preferences for Metastatic Prostate Cancer Treatment: A Discrete Choice Experiment

IF 2.3 3区医学 Q3 ONCOLOGY

Clinical genitourinary cancer Pub Date : 2024-11-01 DOI:10.1016/j.clgc.2024.102254

Yeuk-lam Hong , Chi-fai Ng , Kenneth Chun-wai Wong , Wing-yan Kong , Peter Ka-Fung Chiu , Jeremy Yuen-Chun Teoh , Chi-ho Leung , Pui-tak Lai

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引用次数: 0

Abstract

Background

To examine the preference weightings for risk/benefit attributes of therapy in metastatic prostate cancer (mPC) patients, encompassing hormone-sensitive (mHSPC) and castration-resistant (mCRPC) settings.

Patients and Methods

A noninterventional cross-sectional survey employing a discrete choice experiment was conducted, recruiting 200 mHSPC and 100 mCRPC patients within 5 years of diagnosis from the urology and oncology specialty clinics between Feb 2023 and Jul 2023. Patients were randomized into 2 blocks of 9 questions, choosing 1 out of 2 medication profiles consisting 5 attributes, each with 3 levels, determined from a group interview of 5 patients. A mixed logit model estimated attribute-level preference weightings, with tradeoff points calculated.

Results

Median age was 75 (IQR:71-81), 170 (56.7%) had no income, 245 (81.7%) cared for themselves, mean maximum out-of-pocket treatment cost was US$20,456 (SD:43,568), and 160 (53.3%) claimed not to consider further treatment when cost exceeding their affordability. Patients favoured self-care ability (4.37, P < .001) and life expectancy extension (2.83, P < .001), disfavoured adverse effects (−6.97, P < .001) and treatment cost (in HK$million or USD$128,205) (−3.14, P < .001). mCPRC patients was more sensitive to treatment cost (−3.61 vs. −2.97), life expectancy extension (3.47 vs. 2.55) and adverse effects (−7.55 vs. −6.80) compared to mHSPC patients. Higher financial affordability patients exhibited higher sensitivity to self-care ability (4.89 vs. 4.02) and adverse effects (−7.57 vs. −6.70).

Conclusion

The chance of adverse effects was pivotal in treatment decisions, followed by self-care ability, with cost remaining a major access barrier.

查看原文本刊更多论文

患者对转移性前列腺癌治疗的偏好：离散选择实验。

背景：研究转移性前列腺癌（mPC）患者对治疗风险/收益属性的偏好权重，包括激素敏感型（mHSPC）和阉割耐药型（mCRPC）患者：在 2023 年 2 月至 2023 年 7 月期间，从泌尿科和肿瘤专科门诊招募了 200 名确诊 5 年内的 mHSPC 和 100 名 mCRPC 患者，采用离散选择实验法进行了一项非干预性横断面调查。患者被随机分为 2 组，每组 9 个问题，从 2 个药物配置文件中选择 1 个，这 2 个配置文件由 5 个属性组成，每个属性有 3 个等级，由 5 名患者的小组访谈确定。混合 Logit 模型估算了属性级偏好权重，并计算了权衡点：中位年龄为 75 岁（IQR:71-81），170 人（56.7%）无收入，245 人（81.7%）生活自理，平均最高自付治疗费用为 20,456 美元（SD:43,568），160 人（53.3%）声称在费用超出其承受能力时不会考虑进一步治疗。患者倾向于自我护理能力（4.37，P < .001）和预期寿命延长（2.83，P < .001），不倾向于不良反应（-6.97，P < .001）和治疗费用（以百万港元或 128,205 美元计）（-3.与 mHSPC 患者相比，mCPRC 患者对治疗费用（-3.61 对 -2.97）、预期寿命延长（3.47 对 2.55）和不良反应（-7.55 对 -6.80）更敏感。经济承受能力较高的患者对自我护理能力（4.89 对 4.02）和不良反应（-7.57 对 -6.70）的敏感度较高：不良反应的几率是决定治疗的关键因素，其次是自我护理能力，而费用仍然是获得治疗的主要障碍。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical genitourinary cancer 医学-泌尿学与肾脏学

CiteScore

5.20

自引率

6.20%

发文量

201

审稿时长

54 days

期刊介绍： Clinical Genitourinary Cancer is a peer-reviewed journal that publishes original articles describing various aspects of clinical and translational research in genitourinary cancers. Clinical Genitourinary Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of genitourinary cancers. The main emphasis is on recent scientific developments in all areas related to genitourinary malignancies. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.