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A discrete choice experiment to assess cancer patients’ preferences for when and how to make treatment decisions

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Abstract

Purpose

Cancer patients can be overwhelmed when being confronted with their diagnosis and treatment options. Such information is often provided during one consultation between the patient and treating clinician. In order to achieve optimal cancer care, there may be justification for alternative consultation styles. We assessed, in a sample of adult medical oncology patients, their preferences for (i) attending one 40-min consultation or two 20-min consultations and (ii) receiving written only or both written and online information, when making a cancer treatment decision.

Methods

This was a cross-sectional survey using a discrete choice design of 159 adult medical oncology patients presenting for their second or subsequent outpatient consultation. Participants were presented with a set of hypothetical scenarios and asked to indicate their most and least preferred scenario. The scenarios contained a caveat explaining that there would be no difference between the available treatment options in terms of when treatment would be initiated and the impact it would have on patients’ life expectancy.

Results

One hundred forty-seven patients completed the DCE. Of these, 70% (n = 103) preferred being provided with written and online information rather than just written information. This preference was statistically significant (p < 0.01). Fifty-nine percent (n = 86) of patients preferred two 20-min consultations over one 40-min consultation when making a treatment decision. Significantly, more patients preferred two shorter consultations rather than one longer consultation when this was combined with written and online information (p < 0.01).

Conclusion

When making a cancer treatment decision, clinicians should consider offering patients written and online information, combined with two shorter consultations.

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Acknowledgements

We would like to thank the patients who were involved in this study. We also thank Professor Scott Brown for his contribution to the development and analysis of the DCE.

Funding

Financial support for this study was provided by a Strategic Research Partnership Grant [CSR 11-02] from the Cancer Council New South Wales to the Newcastle Cancer Control Collaborative (New-3C) and by a Partnership Project [APP1059760] from the National Health & Medical Research Council (NHMRC). Anne Herrmann is supported by a University of Newcastle [UNIPRS], a University of Newcastle/Hunter Cancer Research Alliance Research Scholarship [UNRSC5050] and has received funding support from the Hunter Cancer Research Alliance Implementation Science Flagship Program as part of the 2017 RHD Award initiative. Nicholas Zdenkowski is supported by the Hunter New England Local Health District. Amy Waller is funded by an Australian Research Council Discovery Early Career Research Award. We acknowledge infrastructure funding from the University of Newcastle and Hunter Medical Research Institute. The funding agreement ensured the authors’ independence in designing the study, interpreting the data, writing, and publishing the report.

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Authors and Affiliations

  1. Priority Research Centre for Health Behaviour, Health Behaviour Research Group, University of Newcastle and Hunter Medical Research Institute, W4, HMRI Building, University Drive, Callaghan, NSW, 2308, Australia

    Anne Herrmann, Rob Sanson-Fisher, Alix Hall & Amy Waller

  2. School of Psychology, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia

    Laura Wall

  3. Department of Medical Oncology, Calvary Mater Newcastle, Edith St & Platt St, Waratah, NSW, 2298, Australia

    Nicholas Zdenkowski

Authors
  1. Anne Herrmann
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  2. Rob Sanson-Fisher
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  3. Alix Hall
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  4. Laura Wall
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  5. Nicholas Zdenkowski
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  6. Amy Waller
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Contributions

Conception and design: All authors

Collection and assembly of data: All authors

Data analysis and interpretation: Laura Wall, Anne Herrmann, Rob Sanson-Fisher and Alix Hall

Manuscript writing: All authors

Final approval of manuscript: All authors

Accountable for all aspects of the work: All authors

Corresponding author

Correspondence to Anne Herrmann.

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Conflict of interest

The authors declare that they have no competing interests.

Research involving human participants and/or animals

All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in this study.

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Herrmann, A., Sanson-Fisher, R., Hall, A. et al. A discrete choice experiment to assess cancer patients’ preferences for when and how to make treatment decisions. Support Care Cancer 26, 1215–1220 (2018). https://doi.org/10.1007/s00520-017-3944-9

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  • DOI: https://doi.org/10.1007/s00520-017-3944-9

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