Discrete choice experiment for treatment preferences in chronic lymphocytic leukemia
In recent years various new treatment strategies have been developed for the treatment of chronic lymphatic leukemia. Given the differences between these novel approaches—such as treatment duration, route of administration, and adverse event profiles—gaining insight into patient treatment preferences has become increasingly important. Only few studies have explored patient preferences in treatment of CLL. To address this, we conducted a discrete choice experiment (DCE) to assess which treatment attributes are most valued by patients.
In this study a mixed-method approach was used for the selection of attributes and their corresponding levels. For the DCE questionnaire six attributes were selected: administration route, treatment duration, adverse events, long term effects, time to next treatment and possible subsequent therapies after relapse. Participants could take part through an anonymous online survey. Patients, family members and hematologists could take part. An orthogonal design and a mixed logit panel data model were used for statistical analysis.
396 patients filled in the DCE questionnaire. The most important attributes in the choice for making treatment choices were time to next treatment (efficacy), long term effects and administration route. For older patients (>76 years) administration route was more important than for younger patients. Treatment status did not alter the treatment preferences. Patients preferred an oral treatment method over IV administration. Regarding long term effects patients chose to avoid risk of secondary cancer over the risk of cardiac arrythmias or unknown long term effects. There was no difference between patients and caregivers responses.
This study identified patient treatment preferences for Dutch CLL patients. The most important aspect of treatment is the efficacy, however patients also highly value long term effects and administration route. The results of this study can be used by caregivers in discussing treatment options with CLL patients and for future clinical trials.