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

Abstract

Bone metastases and associated skeletal-related events (SREs) are common in patients with advanced breast, lung, and prostate cancer. Bone-targeted agents (BTAs) are available for the treatment of bone metastases, but little is known about patients' and physicians' preferences for the various attributes of these agents. We evaluated preferences for BTAs used to prevent SREs among patients with bone metastases and physicians involved in treating such patients in Turkey. Participants completed an online discretechoice experiment survey of 10 questions, choosing between pairs of hypothetical treatment profiles, defined by five BTA attributes: time to first SRE, time to worsening of pain, annual risk of osteonecrosis of the jaw (ONJ), annual risk of renal impairment, and administration regimen. The analysis included 91 patients and 99 physicians. Both groups rated annual risk of renal impairment, time to worsening of pain, and time to first SRE as the most important BTA attributes. For patients, the preference weights for all levels of these attributes were significantly different, whereas for physicians, preference weights were significantly different for all levels except time to a 2-point increase in "Brief Pain Inventory" score by 6 months or 10 months. Annual risk of ONJ was judged by patients and physicians to be the least important of the BTA attributes. This study adds to the information available on the preferences of patients and physicians for BTAs and provides useful data to aid clinicians in decision-making by understanding the treatment goals that are important to patients in Turkey.Keywords: Bone-targeted agents, Bone metastases, Discrete-choice experiment, Patient preference, Physician preference, Skeletal-related event ÖZET Türkiye'de Kemik Metastazı Tedavisine Yaklaşımda Hasta ve Hekim TercihleriKemik metastazları ve bunlardan kaynaklanan iskeletle ilişkili olaylar (İİO) ilerlemiş meme, akciğer ve prostat kanseri olan hastalarda yaygındır. Kemik metastazlarının tedavisi için kemiği hedef alan ilaçlar (BTA'lar) bulunmakla birlikte, hastaların ve hekimlerin bu ilaçların çeşitli özellikleriyle ilgili tercihlerine ilişkin bilgiler sınırlıdır. Türkiye'de yapılan bu çalışmada, kemik metastazları olan hastalar ile bu tip hastaların tedavisini yürüten hekimlerin SRE'lerin önlenmesine yönelik BTA'larla ilgili tercihleri değerlendirilmiştir. Katılımcılar çevrimiçi yapılan ve 10 soru içeren çoktan seçmeli deney anketini tamamlayarak beş BTA özelliği ile tanımlanan hipotetik tedavi profili çiftleri arasında seçim yapmıştır: ilk SRE'ye kadar geçen süre, ağrının kötüleşmesine kadar geçen süre, yıllık çene osteonekrozu (ONJ) riski, yıllık böbrek yetmezliği riski ve uygulama rejimi. Analize 91 hasta ve 99 hekim dahil edilmiştir. Her iki grup da yıllık böbrek yetmezliği riski, ağrının kötüleşmesine kadar geçen süre ve ilk İİO'ya kadar geçen süreyi en önemli BTA özellikleri olarak değerlendirmiştir.

Do patients and health care providers have discordant preferences about which aspects of treatments matter most? Evidence from a systematic review of discrete choice experiments

“…Piloting in all target groups was more common (12 of 24 studies reporting piloting), and a number of studies that did not report generating attributes in all groups reported piloting their survey in all respondents. 40 42 47 50 52 …”