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Qualitative Study of Factors Affecting Patient, Caregiver and Physician Preferences for Treatment of Myeloma and Indolent Lymphoma

Authors Jen WY, Yoong J, Liu X, Tan MSY, Chng WJ, Chee YL

Received 6 December 2019

Accepted for publication 30 January 2020

Published 17 February 2020 Volume 2020:14 Pages 301—308


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen

Wei-Ying Jen,1 Joanne Yoong,2 Xin Liu,1 Melinda Si Yun Tan,3 Wee Joo Chng,1 Yen-Lin Chee1

1Department of Haematology-Oncology, National University Cancer Institute, Singapore; 2Centre for Health Services and Policy Research, Saw Swee Hock School of Public Health, National University of Singapore, Singapore; 3Department of Haematology, Singapore General Hospital, Singapore

Correspondence: Wei-Ying Jen
Department of Haematology-Oncology, National University Cancer Institute, 1E Kent Ridge Road, NUHS Tower Block Level 7, 119228, Singapore
Tel +65 6772 5286
Fax +65 6772 2998

Introduction: The number of treatment options for myeloma and indolent lymphoma are expanding at an exponential rate, with few direct head-to-head comparisons on which to base efficacy measures. We sought to understand how patients, their caregivers and physicians weigh treatment characteristics in order to come to a decision on which treatment option to pursue.
Methods: Patients, their caregivers and physicians were recruited and interviewed until data saturation was reached. A qualitative, thematic analysis was done to identify themes important to each stakeholder.
Results: We found that, while all three groups valued efficacy the most, the consideration of other secondary characteristics of the treatment, such as cost, toxicity and logistical issues all differed subtly between the different groups. Patients valued minimising cost and toxicity, even at small trade-offs in efficacy. Caregivers and physicians valued efficacy foremost.
Conclusion: Acknowledging and managing these differences is paramount because they influence shared decision-making and may affect patient outcomes in the short term, as well as their more general well-being in the long term.

Keywords: patient preferences, treatment options, myeloma, lymphoma

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