Alignment of preferences in the treatment of multiple myeloma - a discrete choice experiment of patient, carer, physician, and nurse preferences

• Published in: BMC cancer Vol. 20; no. 1; p. 546
• Main Authors: Fifer, Simon J, Ho, Kerrie-Anne, Lybrand, Sean, Axford, Laurie J, Roach, Steve
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 11.06.2020; BioMed Central; BMC
• Subjects: Adult; Aged; Aged, 80 and over; Australia; Bone marrow; Caregivers; Caregivers - statistics & numerical data; Carer preferences; Cell proliferation; Choice Behavior; Comparative analysis; Decision making; Discrete choice experiment; Drug therapy; Female; Health Expenditures; Hematology; Humans; Literature reviews; Male; Medical prognosis; Middle Aged; Multiple myeloma; Multiple Myeloma - therapy; Nurse preferences; Nurses; Nurses - statistics & numerical data; Out of pocket costs; Patient compliance; Patient Preference - statistics & numerical data; Patient preferences; Patients; Physician preferences; Physicians; Physicians - statistics & numerical data; Plasma cells; Preferences; Qualitative research; Quality of life; Remission; Surveys; Young Adult; Australia; Patient preferences; Carer preferences; Nurse preferences; Multiple myeloma; Physician preferences; Conjoint analysis; Discrete choice experiment
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-020-07018-6

Multiple Myeloma (MM) is a cancer characterised by the proliferation of malignant plasma cells in the bone marrow. This study examined the treatment preferences of people living with MM compared to the treatment preferences of other groups involved in treatment decision making, including carers, as well as physicians and nurses who treat people living with MM in Australia. Data were collected using discrete choice experiments (DCEs) through an online survey. The DCEs presented participants with a traditional treatment generic choice experiment (e.g., treatment A vs treatment B), focusing on the clinical benefits of treatments and the associated risks. The attributes and levels of the attributes were selected based on previous research, literature review, qualitative research and expert opinion. The DCE data were modelled using a Latent Class Model (LCM). The model revealed significant heterogeneity in preferences for treatment attributes. In particular, overall survival, remission period and annual out of pocket cost were the attributes with the most variation. In comparison to people living with MM, carers were less cost-sensitive and more concerned with quality of life (remission period). Physicians and nurses were generally more concerned with overall survival and more cost sensitive than people living with MM. This study demonstrated that not all people living with MM valued the same treatment attributes equally. Further, not all groups involved in MM treatment decision making had preference alignment on all treatment attributes. This has important implications for healthcare policy decisions and shared decision making. Results from this study could be used to guide decisions around the value of new MM medicines or the medical plan surrounding the needs of those living with MM, as well as those caring for them.