Prioritäten bei der Therapie des Multiplen Myeloms: Eine Analyse der Perspektive von ÄrztenReport as inadecuate

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PharmacoEconomics German Research Articles

, Volume 11, Issue 2, pp 77–88

First Online: 11 March 2014


BackgroundCurrently there is no cure for patients with Multiple Myeloma. Hence the primary objective of treatment is to extend survival time at the best possible quality of life. A study for eliciting patient preferences in multiple myeloma was conducted in summer-autumn of 2007. Target audiences have been the patients themselves. In the present study the questionnaire for preferences was presented to physicians, asking about their opinion as to what patients might consider most important. The aim of this second preference survey was to determine the physicians’ notions of their patients’ preference patterns, and to find out whether they were consistent with the patients’ actual preferences.

Study Design Including Statistical DesignThe study consisted of two parts: a pre-test as a qualitative preliminary survey aimed at establishing relevant parameters, and a quantitative principal study with the objective of determining patients’ preferences as seen from the perspective of physicians as decision-makers. This part includes a direct assessment for levels of importance in a total of 17 aspects 5-point Likert scale and a Discrete-choice experiment for measuring preferences, consisting of eight pairs with eight characteristics each.

Sample and MethodsThe principal survey was conducted from early February to early March 2008 by means of online questionnaires or by use of a paper. In total N=511 physicians’ were asked by e-mail to participate in the survey; physicians without an e-mail address N=614 were sent a paper questionnaire. A total of 243 physicians answered the questionnaire; 76 % male, 62 % with a specialization in haematology.

ResultsIn the direct measurement of patients’ preferences, physicians rated physical quality of life, rare side effects, and effectiveness aspects as most important attributes from the patients’ perspective, followed by emotional quality of life and therapy-free-intervals. Especially further treatment options and dosage were more important to patients than physicians believed. In this case, the physicians had underestimated the importance of these attributes from the perspective of those affected. The experiment revealed that both groups agree that openness to further therapy options and maximum extension of life are the most important factors. Physicians ranked prolonged life expectancy as significantly more important than all other treatment attributes. A further treatment option was the second most important attribute and significant compared to the attributes breaks in therapy and physical quality of life.

ConclusionsAsking physicians about the patients’ treatment preferences, the combination of direct assessment and Discrete-choice experiment proves to be a valid survey technique. Both the direct assessment of importance in order to rank the patients’ perceptions and the Discrete-choice experiment provide important insights into the preference structure of patients with Multiple Myeloma.

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Author: Axel C. Mühlbacher - Matthias Nübling


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