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What influences healthcare professionals' treatment preferences for older women with operable breast cancer? An application of the discrete choice experiment

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journal contribution
posted on 23.11.2017, 10:11 by J. L. Morgan, S. J. Walters, K. Collins, Thompson G. Robinson, K.-L. Cheung, R. Audisio, M. W. Reed, L. Wyld
INTRODUCTION: Primary endocrine therapy (PET) is used variably in the UK as an alternative to surgery for older women with operable breast cancer. Guidelines state that only patients with "significant comorbidity" or "reduced life expectancy" should be treated this way and age should not be a factor. METHODS: A Discrete Choice Experiment (DCE) was used to determine the impact of key variables (patient age, comorbidity, cognition, functional status, cancer stage, cancer biology) on healthcare professionals' (HCP) treatment preferences for operable breast cancer among older women. Multinomial logistic regression was used to identify associations. RESULTS: 40% (258/641) of questionnaires were returned. Five variables (age, co-morbidity, cognition, functional status and cancer size) independently demonstrated a significant association with treatment preference (p < 0.05). Functional status was omitted from the multivariable model due to collinearity, with all other variables correlating with a preference for operative treatment over no preference (p < 0.05). Only co-morbidity, cognition and cancer size correlated with a preference for PET over no preference (p < 0.05). CONCLUSION: The majority of respondents selected treatment in accordance with current guidelines, however in some scenarios, opinion was divided, and age did appear to be an independent factor that HCPs considered when making a treatment decision in this population.

History

Citation

European Journal of Surgical Oncology, 2017, 43 (7), pp. 1282-1287

Author affiliation

/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/School of Medicine/Department of Cardiovascular Sciences

Version

AM (Accepted Manuscript)

Published in

European Journal of Surgical Oncology

Publisher

WB Saunders for BASO - the Association for Cancer Surgery and European Society of Surgical Oncology

issn

0748-7983

eissn

1532-2157

Acceptance date

08/01/2017

Copyright date

2017

Available date

23/11/2017

Publisher version

http://www.sciencedirect.com/science/article/pii/S0748798317301075?via=ihub#!

Language

en