Treatment decision-making in chronic lymphocytic leukaemia : Key factors for healthcare professionals. PRELIC study
Boque, Concepcion (Institut Català d'Oncologia)
Abad, María Reyes (Hospital Universitario Miguel Servet (Saragossa))
Agustin Ferrandez, Maria Jose (Hospital Universitario Miguel Servet (Saragossa))
García-Goñi, Manuel (Universidad Complutense de Madrid)
Moreno, Carolina M. (Institut d'Investigació Biomèdica Sant Pau)
Gabás-Rivera, Clara (Outcomes 10)
Granados, Enrique (Gilead Sciences)
Castro-Gómez, Antonio (Gilead Sciences)
Pardo, Carlos (Gilead Sciences)
Lizán, Luis (Universitat Jaume I)

Fecha:	2020
Resumen:	To explore the preferences of Spanish healthcare professionals (haematologists and hospital pharmacists) for the treatment selection of active Chronic Lymphocytic Leukaemia (CLL) patients at first relapse, condition that mainly afflicts older adults. A discrete choice experiment (DCE) was conducted among haematologists and hospital pharmacists. A literature review and a focus group informed the DCE design. CLL treatment settings were defined by seven attributes: four patient/disease-related attributes (age, functional status, comorbidities, and risk of the disease) and three treatment-related attributes (efficacy [hazard ratio of progression-free survival, HR-PFS], rate of discontinuations due to adverse events and cost). A mixed-logit model was used to determine choice-based preferences. Relative importance (RI) of attributes was calculated and compared between stakeholders. Willingness-to-pay (WTP) was estimated through the DCE. Besides, nine ad-hoc questions were posed, to explore more in depth CLL treatment decision making. A total of 130 participants (72 haematologists and 58 hospital pharmacists) answered the DCE. All attributes were significant predictors of preferences (p < 0. 05) in the multinomial model. Higher RI was obtained for treatment-related attributes: the highest rated being 'cost' (23. 8%) followed by 'efficacy' (20. 9%). Regarding patient-related attributes, the highest RI was obtained for 'age' (18. 1%). No significant differences (p > 0. 05) in RI between haematologists and pharmacists were found. WTP for the treatment was higher for younger CLL patients. Ad-hoc questions showed that patient age and functional status influence treatment decisions. For healthcare professionals, 'cost' and 'efficacy' (treatment-related attributes) and age (patient-related attribute) are the main factors that determine CLL treatment selection at first relapse. WTP decreases as patient's age increases.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Ageism ; Chronic lymphocytic leukaemia ; Decision-making ; Discrete choice experiment ; Drug cost ; Elderly ; Healthcare professionals ; Physiological age ; Preferences
Publicado en:	Journal of Geriatric Oncology, Vol. 11 Núm. 1 (january 2020) , p. 24-30, ISSN 1879-4068

DOI: 10.1016/j.jgo.2019.03.010
PMID: 30954406

7 p, 442.8 KB

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