Nurses’ Preferences for Bone Metastases Treatments in the United States

Abstract

Objectives: To evaluate European physicians' treatment preferences for preventing skeletal-related events (SREs) in patients with bone metastases from solid tumors. MethOds: Physicians completed an online discrete-choice experiment survey consisting of 10 choices between pairs of hypothetical medication profiles for a putative patient. Each profile included five attributes within a pre-defined range (based on prescribing information for the available bone-targeted agents [BTA]): months until first SRE (10, 18 and 28 months); months until worsening of pain (3, 6 and 10 months); annual risk of osteonecrosis of the jaw (ONJ; 0, 1 and 5%); annual risk of renal impairment (0, 4 and 10%); and mode of administration (oral tablet, subcutaneous injection, 15-minute infusion and 120-minute infusion). Choice questions were based on an experimental design with known statistical properties. The survey was pretested with 8 physicians using open-ended interviews. A separate main-effects random parameters logit model was estimated for each country. Results: Physicians from France (n= 191), Germany (n= 192) and the UK (n= 197) completed the survey. Among the attributes included in the survey, months until first SRE and the risk of renal impairement were the most important attributes in France and the UK, whereas in Germany months until first SRE and a delay in worsening of pain were the most important. For all these attributes, better levels were significantly preferred to worse levels (p< 0.05). In all three countries, a 120-minute infusion every 4 weeks was the least preferred mode of administration (p< 0.05). The annual risk of ONJ was judged by physicians to be the least important attribute in all three countries. cOnclusiOns: Physicians generally make treatment decisions regarding choice of BTA for patients with bone metastases based on intent to delay the onset of SREs, managing risk of renal impairment and preventing the worsening of pain.

Patients’ and Physicians’ Preferences for Approaches to Bone Metastases Treatment in Turkey

“…14,15 In a study of physicians, patients, caregivers, and nurses in the USA, out-of-pocket cost to patients, time to first SRE, and risk of renal impairment were rated as the most important BTA attributes by each group. [30][31][32] These studies confirm that treatments that delay SREs and worsening of pain with a low risk of renal impairment are desirable in the opinions of both patients and physicians across Europe and the USA.…”