Myeloma UK are passionate about ensuring patients have access to the treatments that are right for them. As a result, one of the aims of a recent project in our Health Services Research Programme was to understand how myeloma patients choose between different treatment options and identify what treatment attributes are most important to them.
A Myeloma UK study, recently published in Patient Preference and Adherence, explored how myeloma patients make decisions about their treatment. The study aimed to identify which treatment benefits patients value the most and what risk-benefit trade-offs they are willing to make.
In the study, the treatment preferences of 475 myeloma patients were assessed using an online discrete choice experiment (DCE). In the DCE patients were asked to decide between two hypothetical treatments or no treatment. The treatment choices were described using seven attributes: mode of administration, frequency of administration, out of pocket costs, average overall survival, average remission period, risk of mild to moderate side effects and risk of serious side effects. Each patient had to evaluate ten different choice scenarios.
The study showed that average survival, risk of severe side effects and treatment administration were considered the most important attributes to patients overall.
Further analysis of the data indicated that patients value the attributes differently. The researchers identified two distinct patient groups. Group 1 focused on average survival and mild to moderate side effects. Group 2 placed more importance on out of pocket costs and the mode and frequency of treatment.
When looking at the patient demographics those living with others and those diagnosed in the last five years were more likely to be in group 1. Patients who have been on treatment for longer were more likely to be in group 2.
This work indicates that the most appropriate treatment will differ across patients. It highlights the importance of looking at the patient holistically when making treatment decisions and that their preferences and quality of life should be considered. Therefore, to aid joint decision-making healthcare professionals should also provide patients with information about treatment administration (mode and frequency), the number of hospital visits and the risk of side effects as well as efficacy.