肌层浸润性膀胱癌患者的治疗偏好：离散选择实验

IF 1.6 Q3 UROLOGY & NEPHROLOGY BJUI compass Pub Date : 2024-10-11 DOI:10.1002/bco2.443

Liam Mannion, Verity Watson, Vinod Mullassery, Rajesh Nair, Thomas Charlton, Margaret Northover, Deborah Enting, Mieke Van Hemelrijck, Muhammad Shamim Khan, Ramesh Thurairaja, Suzanne Amery, Kathryn Chatterton, Kate Smith, Simon Hughes

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引用次数: 0

摘要

背景：面对治疗方案时，患者需要参与决策。我们试图确定肌肉浸润性膀胱癌（MIBC）患者最关心哪些治疗方面，以加深对患者偏好以及患者愿意接受哪些权衡的理解。我们的研究包括离散选择实验（DCE）：这是一种用于在没有实际选择的情况下征求偏好的问卷：离散选择实验有五个属性，每个属性有三个等级。受试者被要求填写一份问卷，其中要求他们在两种假定的 MIBC 治疗方法中做出选择。我们使用条件对数模型对数据进行了分析，并对属性的偏好和属性之间的权衡进行了估算：我们招募了已经完成、正在进行或尚未开始根治性治疗的 MIBC 患者（n = 60）。参与者对延长预期寿命（p = p = p = p = 0.09）或增加急性副作用（p = 0.99）的治疗方法有强烈偏好，但这并不影响偏好。患者愿意接受长期并发症风险较高的治疗方法，以改善其预期寿命或身体形象：结论：在决定治疗类型时，延长预期寿命是MIBC患者最重要的考虑因素。结论：在决定治疗方式时，延长预期寿命是宫颈癌患者最重要的考虑因素，长期并发症的风险和治疗对整体身体形象的改变也很重要。我们的研究还强调，患者愿意接受较高的长期并发症风险，以改善其他治疗效果。了解患者的偏好对于共同决策非常重要，而共同决策对 MIBC 患者的护理质量也有影响。

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Treatment preferences of patients with muscle invasive bladder cancer: A discrete choice experiment

Background

When faced with treatment options, patients are asked to participate in decision-making. We sought to determine which treatment aspects matter most for individuals treated for muscle invasive bladder cancer (MIBC), with an aim to improve understanding of patient preferences and what trade-offs patients are willing to accept. Our study consisted of a discrete choice experiment (DCE): a type of questionnaire used to elicit preferences in the absence of real-world choice.

Methods

The DCE had five attributives, each with three levels. Participants were asked to complete a questionnaire in which they were asked to choose between two hypothetical MIBC treatments. The data were analysed using a conditional logit model, and preferences for, and trade-offs between, attributes were estimated.

Results

We recruited patients with MIBC who had either already completed, were undergoing or had yet to commence radical treatment for MIBC (n = 60). Participants indicated a strong preference for treatments that increased their life expectancy (p = <0.001), had a lower risk of long-term complications (p = <0.001) and less changes to their body image (p = <0.001). Changes to sexual wellbeing (p = 0.09) or an increase in acute side effects (p = 0.99) did not influence preferences. Patients were willing to accept treatments with higher risk of long-term complications to improve their life expectancy or body image.

Conclusion

When deciding on the type of treatment, increased life expectancy is the most important consideration for people with MIBC. The risk of long-term complications and changes to overall body image as a result of treatment are also important. Our study also highlighted that patients are willing to accept a higher risk of long-term complications to improve other treatment outcomes. Understanding patient preferences is important for shared decision-making, which has an impact on quality of care for people living with MIBC.

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