Oncologist and Patient Preferences for Novel Agents in First-Line Treatment for Chronic Lymphocytic Leukemia: Commonalities and Disconnects
Hannah Le,1 Kellie Ryan,1 Svea K Wahlstrom,2 Martine C Maculaitis,3 Oliver Will,4 Emily Mulvihill,5 Thomas W LeBlanc6 1US Medical Affairs, AstraZeneca, Gaithersburg, MD, USA; 2US Patient Safety, AstraZeneca, Wilmington, DE, USA; 3Kantar, Health Division, New York, NY, USA; 4Kantar, Health Division,...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2021-01-01
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| Series: | Patient Preference and Adherence |
| Subjects: | |
| Online Access: | https://www.dovepress.com/oncologist-and-patient-preferences-for-novel-agents-in-first-line-trea-peer-reviewed-article-PPA |
| _version_ | 1818392792983928832 |
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| author | Le H Ryan K Wahlstrom SK Maculaitis MC Will O Mulvihill E LeBlanc TW |
| author_facet | Le H Ryan K Wahlstrom SK Maculaitis MC Will O Mulvihill E LeBlanc TW |
| author_sort | Le H |
| collection | DOAJ |
| description | Hannah Le,1 Kellie Ryan,1 Svea K Wahlstrom,2 Martine C Maculaitis,3 Oliver Will,4 Emily Mulvihill,5 Thomas W LeBlanc6 1US Medical Affairs, AstraZeneca, Gaithersburg, MD, USA; 2US Patient Safety, AstraZeneca, Wilmington, DE, USA; 3Kantar, Health Division, New York, NY, USA; 4Kantar, Health Division, Horsham, PA, USA; 5Kantar, Health Division, St. Louis, MO, USA; 6Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC, USACorrespondence: Martine C Maculaitis Email Martine.Maculaitis@kantar.comPurpose: Treatment for chronic lymphocytic leukemia (CLL) has changed dramatically with the approval of novel agents. Information regarding how patients and oncologists make trade-offs across attributes of novel therapies is limited. The purpose of this study was to understand how variations in attributes impact treatment choice among patients and oncologists.Patients and Methods: In this study, 371 participants (patients [n=220] and oncologists [n=151]) completed an online discrete choice experiment (DCE) to quantify preferences for first-line (1L) CLL treatment with novel agents; participants chose between hypothetical treatment profiles consisting of eight attributes with varying levels taken from published literature. Hierarchical Bayesian models were used to estimate attribute level preference weights. The weights were used to compute relative importance, a measure of how influential an attribute is to treatment choice.Results: Increasing 2-year progression-free survival (PFS) from 75% to 95% had the greatest impact on preferences in 1L CLL treatment, accounting for 40% and 30% of the variation in preferences among patients and oncologists, respectively. Risk differences in atrial fibrillation (AF), infection, and discontinuation due to adverse events (AEs) were also important to patients and oncologists. Among both groups, risk differences in tumor lysis syndrome (TLS) and bleeding were least influential in treatment choice. Oncologists required 2– 4 times higher increases in 2-year PFS than patients to accept increased risks of AF, discontinuation due to AEs, bleeding, TLS, and arthralgia/myalgia.Conclusion: Patient–oncologist communication may be improved by a more focused discussion on the risks of AEs, relative to treatment outcomes, with patient goals in mind.Keywords: leukemia, lymphocytic, chronic, B-cell, progression-free survival, tumor lysis syndrome, oncologists |
| first_indexed | 2024-12-14T05:35:03Z |
| format | Article |
| id | doaj.art-b485c072dbad4411b7ae989b2144f26c |
| institution | Directory Open Access Journal |
| issn | 1177-889X |
| language | English |
| last_indexed | 2024-12-14T05:35:03Z |
| publishDate | 2021-01-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Patient Preference and Adherence |
| spelling | doaj.art-b485c072dbad4411b7ae989b2144f26c2022-12-21T23:15:12ZengDove Medical PressPatient Preference and Adherence1177-889X2021-01-01Volume 159911061358Oncologist and Patient Preferences for Novel Agents in First-Line Treatment for Chronic Lymphocytic Leukemia: Commonalities and DisconnectsLe HRyan KWahlstrom SKMaculaitis MCWill OMulvihill ELeBlanc TWHannah Le,1 Kellie Ryan,1 Svea K Wahlstrom,2 Martine C Maculaitis,3 Oliver Will,4 Emily Mulvihill,5 Thomas W LeBlanc6 1US Medical Affairs, AstraZeneca, Gaithersburg, MD, USA; 2US Patient Safety, AstraZeneca, Wilmington, DE, USA; 3Kantar, Health Division, New York, NY, USA; 4Kantar, Health Division, Horsham, PA, USA; 5Kantar, Health Division, St. Louis, MO, USA; 6Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC, USACorrespondence: Martine C Maculaitis Email Martine.Maculaitis@kantar.comPurpose: Treatment for chronic lymphocytic leukemia (CLL) has changed dramatically with the approval of novel agents. Information regarding how patients and oncologists make trade-offs across attributes of novel therapies is limited. The purpose of this study was to understand how variations in attributes impact treatment choice among patients and oncologists.Patients and Methods: In this study, 371 participants (patients [n=220] and oncologists [n=151]) completed an online discrete choice experiment (DCE) to quantify preferences for first-line (1L) CLL treatment with novel agents; participants chose between hypothetical treatment profiles consisting of eight attributes with varying levels taken from published literature. Hierarchical Bayesian models were used to estimate attribute level preference weights. The weights were used to compute relative importance, a measure of how influential an attribute is to treatment choice.Results: Increasing 2-year progression-free survival (PFS) from 75% to 95% had the greatest impact on preferences in 1L CLL treatment, accounting for 40% and 30% of the variation in preferences among patients and oncologists, respectively. Risk differences in atrial fibrillation (AF), infection, and discontinuation due to adverse events (AEs) were also important to patients and oncologists. Among both groups, risk differences in tumor lysis syndrome (TLS) and bleeding were least influential in treatment choice. Oncologists required 2– 4 times higher increases in 2-year PFS than patients to accept increased risks of AF, discontinuation due to AEs, bleeding, TLS, and arthralgia/myalgia.Conclusion: Patient–oncologist communication may be improved by a more focused discussion on the risks of AEs, relative to treatment outcomes, with patient goals in mind.Keywords: leukemia, lymphocytic, chronic, B-cell, progression-free survival, tumor lysis syndrome, oncologistshttps://www.dovepress.com/oncologist-and-patient-preferences-for-novel-agents-in-first-line-trea-peer-reviewed-article-PPAleukemialymphocyticchronicb-cellprogression-free survivaltumor lysis syndromeoncologists |
| spellingShingle | Le H Ryan K Wahlstrom SK Maculaitis MC Will O Mulvihill E LeBlanc TW Oncologist and Patient Preferences for Novel Agents in First-Line Treatment for Chronic Lymphocytic Leukemia: Commonalities and Disconnects Patient Preference and Adherence leukemia lymphocytic chronic b-cell progression-free survival tumor lysis syndrome oncologists |
| title | Oncologist and Patient Preferences for Novel Agents in First-Line Treatment for Chronic Lymphocytic Leukemia: Commonalities and Disconnects |
| title_full | Oncologist and Patient Preferences for Novel Agents in First-Line Treatment for Chronic Lymphocytic Leukemia: Commonalities and Disconnects |
| title_fullStr | Oncologist and Patient Preferences for Novel Agents in First-Line Treatment for Chronic Lymphocytic Leukemia: Commonalities and Disconnects |
| title_full_unstemmed | Oncologist and Patient Preferences for Novel Agents in First-Line Treatment for Chronic Lymphocytic Leukemia: Commonalities and Disconnects |
| title_short | Oncologist and Patient Preferences for Novel Agents in First-Line Treatment for Chronic Lymphocytic Leukemia: Commonalities and Disconnects |
| title_sort | oncologist and patient preferences for novel agents in first line treatment for chronic lymphocytic leukemia commonalities and disconnects |
| topic | leukemia lymphocytic chronic b-cell progression-free survival tumor lysis syndrome oncologists |
| url | https://www.dovepress.com/oncologist-and-patient-preferences-for-novel-agents-in-first-line-trea-peer-reviewed-article-PPA |
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