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3 results on '"treatment-related decision making"'

1. Anticoagulation treatment in cancer-Associated venous thromboembolism: Assessment of patient preferences using a discrete choice experiment (cosimo study)

Author

Picker, N, Lee, A, Cohen, A, Maraveyas, A, Beyer-Westendorf, J, Mantovani, L, Abdelgawwad, K, Fatoba, S, Thate-Waschke, I, Bach, M, Wilke, T, Picker N., Lee A. Y., Cohen A. T., Maraveyas A., Beyer-Westendorf J., Mantovani L. G., Abdelgawwad K., Fatoba S., Thate-Waschke I. -M., Bach M., Wilke T., Picker, N, Lee, A, Cohen, A, Maraveyas, A, Beyer-Westendorf, J, Mantovani, L, Abdelgawwad, K, Fatoba, S, Thate-Waschke, I, Bach, M, Wilke, T, Picker N., Lee A. Y., Cohen A. T., Maraveyas A., Beyer-Westendorf J., Mantovani L. G., Abdelgawwad K., Fatoba S., Thate-Waschke I. -M., Bach M., and Wilke T.

Abstract

Introduction â Clinical guidelines recommend anticoagulation therapy for the treatment of cancer-Associated venous thromboembolism (VTE), but little is known about preferences. Therefore, the objective of this discrete choice experiment (DCE) was to elucidate patient preferences regarding anticoagulation convenience attributes. Methods â Adult patients with cancer-Associated VTE who switched to direct oral anticoagulants were included in a single-Arm study (COSIMO). Patients were asked to decide between hypothetical treatment options based on a combination of the following attributes: route of administration (injection/tablet), frequency of intake (once/twice daily), need for regular controls of the international normalized ratio (INR) at least every 3 to 4 weeks (yes/no), interactions with food/alcohol (yes/no), and distance to treating physician (1 vs. 20 km) as an additional neutral attribute. DCE data were collected by structured telephone interviews and analyzed based on a conditional logit regression. Results â Overall, 163 patients (mean age 63.7 years, 49.1% female) were included. They strongly preferred oral administration compared with self-injections (importance of this attribute for overall treatment decisions: 73.8%), and a treatment without dietary restrictions (11.8%). Even if these attributes were less important (7.2% and 6.5%, respectively), patients indicated a preference for a shorter distance to the treating physician and once-daily dosing compared with twice-daily intake. Need for regular controls of INR at least every 3 to 4 weeks showed no significant impact on the treatment decision (0.7%). Conclusion â This study showed that treatment-related decision making in cancer-Associated VTE, assuming comparable effectiveness and safety of anticoagulant treatments, is predominantly driven by route of administration, with patients strongly preferring oral administration.

Published
2021

2. Anticoagulation treatment in cancer-Associated venous thromboembolism: Assessment of patient preferences using a discrete choice experiment (cosimo study)

Author

Alexander T. Cohen, Inga-Marion Thate-Waschke, Agnes Y.Y. Lee, Samuel Fatoba, Jan Beyer-Westendorf, Miriam Bach, Lorenzo G. Mantovani, Nils Picker, Thomas Wilke, Khaled Abdelgawwad, Anthony Maraveyas, Picker, N, Lee, A, Cohen, A, Maraveyas, A, Beyer-Westendorf, J, Mantovani, L, Abdelgawwad, K, Fatoba, S, Thate-Waschke, I, Bach, M, and Wilke, T

Subjects
Male, medicine.medical_specialty, Stroke, Systemic or Venous Thromboembolism, medicine.drug_class, Discrete choice experiment, 030204 cardiovascular system & hematology, Logistic regression, 03 medical and health sciences, Route of administration, 0302 clinical medicine, Oral administration, Internal medicine, Neoplasms, medicine, Humans, 030212 general & internal medicine, Dosing, Prospective Studies, anticoagulation, Stroke, cancer-Associated venous thromboembolism, Aged, business.industry, Drug Administration Routes, Anticoagulant, discrete choice experiment, Cancer, Anticoagulants, Hematology, Venous Thromboembolism, Middle Aged, medicine.disease, treatment-related decision making, Female, business, patient preferences, patient preference
Abstract

Introduction Clinical guidelines recommend anticoagulation therapy for the treatment of cancer-associated venous thromboembolism (VTE), but little is known about preferences. Therefore, the objective of this discrete choice experiment (DCE) was to elucidate patient preferences regarding anticoagulation convenience attributes. Methods Adult patients with cancer-associated VTE who switched to direct oral anticoagulants were included in a single-arm study (COSIMO). Patients were asked to decide between hypothetical treatment options based on a combination of the following attributes: route of administration (injection/tablet), frequency of intake (once/twice daily), need for regular controls of the international normalized ratio (INR) at least every 3 to 4 weeks (yes/no), interactions with food/alcohol (yes/no), and distance to treating physician (1 vs. 20 km) as an additional neutral attribute. DCE data were collected by structured telephone interviews and analyzed based on a conditional logit regression. Results Overall, 163 patients (mean age 63.7 years, 49.1% female) were included. They strongly preferred oral administration compared with self-injections (importance of this attribute for overall treatment decisions: 73.8%), and a treatment without dietary restrictions (11.8%). Even if these attributes were less important (7.2% and 6.5%, respectively), patients indicated a preference for a shorter distance to the treating physician and once-daily dosing compared with twice-daily intake. “Need for regular controls of INR at least every 3 to 4 weeks” showed no significant impact on the treatment decision (0.7%). Conclusion This study showed that treatment-related decision making in cancer-associated VTE, assuming comparable effectiveness and safety of anticoagulant treatments, is predominantly driven by “route of administration,” with patients strongly preferring oral administration.

Published
2021

3. Adjuvant Chemotherapy in Older Adults With Colon Cancer.

Author

Williams, Grant R. and Sanoff, Hanna K.

Subjects
ANTINEOPLASTIC agents, ELDER care, CANCER chemotherapy, CANCER patient medical care, COLON tumors, COMBINED modality therapy, DECISION making, DECISION making in clinical medicine, OLD age
Abstract

Colorectal cancer (CRC) is predominately a disease of older adults, with the median age of diagnosis 68 years; 59% of all cases are diagnosed in persons age 65 years or older. Although older patients have been underrepresented in clinical trials, pooled analysis suggests similar treatment benefits with fluorouracil and leucovorin (5FU/LV) for older patients compared with younger patients, while the evidence of treatment benefit from oxaliplatin-containing regimens is less compelling. Many helpful tools that provide estimates of prognosis, risk of recurrence, risk of severe toxicity with chemotherapy, and functional age can aid clinical decisions. In this review, we present the evidence for adjuvant chemotherapy in older adults, discuss helpful tools that can aid in adjuvant decision making, and present a suggested treatment approach to adjuvant chemotherapy in older adults with CRC. [ABSTRACT FROM AUTHOR]

Published
2015

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