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Patient preferences for reducing toxicities of treatments for gastrointestinal stromal tumor (GIST).

Hauber AB, Gonzalez JM, Coombs J, Sirulnik A, Palacios D, Scherzer N - Patient Prefer Adherence (2011)

Bottom Line: Reducing heart failure from moderate to mild and diarrhea from severe to moderate had the largest effects on subjects' evaluation of adherence.Treating or reducing severe toxicities is much more important to patients than treating or reducing moderate toxicities.Focused reductions of certain toxicities may improve treatment adherence.

View Article: PubMed Central - PubMed

Affiliation: RTI Health Solutions, Research Triangle Park, NC, USA;

ABSTRACT

Purpose: To quantify gastrointestinal stromal tumor (GIST) patients' preferences for reducing treatment toxicities and the likely effect of toxicities on patients' stated adherence.

Methods: English-speaking members of the Life Raft Group, a GIST patient advocacy and research organization, aged 18 years and older, completed a web-enabled survey including a series of treatment-choice questions, each presenting a pair of hypothetical GIST medication toxicity profiles. Each profile was defined by common or concerning toxicities verified via pretest interviews including: severity of edema, diarrhea, nausea, fatigue, rash, hand-foot syndrome, and heart failure; and risk of serious infection. Each subject answered 13 choice-format questions based on a predetermined experimental design with known statistical properties. Subjects were asked to rate the likelihood that they would miss or skip doses of medications with different toxicity profiles. Random-parameters logit was used to estimate a relative preference weight for each level of toxicity.

Results: 173 subjects completed the survey. Over the ranges of toxicity levels included in the study, heart failure was the most important toxicity. Edema was the least important. For all toxicities, reducing severity from severe to moderate was more important to subjects than reducing severity from moderate to mild. Reducing heart failure from moderate to mild and diarrhea from severe to moderate had the largest effects on subjects' evaluation of adherence.

Conclusions: All toxicities included in the study are important to patients. Treating or reducing severe toxicities is much more important to patients than treating or reducing moderate toxicities. Focused reductions of certain toxicities may improve treatment adherence.

No MeSH data available.


Related in: MedlinePlus

Adherence weights.
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f3-ppa-5-307: Adherence weights.

Mentions: The first stage of the adherence rating model indicated that patients who discuss treatment toxicities with other GIST patients and patients who had had prior surgery to treat GIST were more likely to choose something other than “Equally likely to miss or skip doses with Medicine A and Medicine B”. In contrast, married patients and patients who discussed treatment toxicities with a pharmacist or specialist were less likely to indicate that treatment toxicities will affect the likelihood of missing or skipping doses than patients without prior treatment experience. We found no effect of employment on the likelihood that a patient would miss or skip doses. In the second stage of the model, all toxicities had an impact on the likelihood of missing or skipping doses. The effect of each toxicity level on likely adherence is presented in Figure 3. Reducing the severity of congestive heart failure from moderate to mild and reducing the severity of diarrhea from severe to moderate had the largest effect on likely adherence. Reducing the likelihood of serious infection from 12% to 6% had the third largest effect on likely adherence. In contrast, reducing the severity of edema from moderate to mild had the smallest effect on likely adherence.


Patient preferences for reducing toxicities of treatments for gastrointestinal stromal tumor (GIST).

Hauber AB, Gonzalez JM, Coombs J, Sirulnik A, Palacios D, Scherzer N - Patient Prefer Adherence (2011)

Adherence weights.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3140312&req=5

f3-ppa-5-307: Adherence weights.
Mentions: The first stage of the adherence rating model indicated that patients who discuss treatment toxicities with other GIST patients and patients who had had prior surgery to treat GIST were more likely to choose something other than “Equally likely to miss or skip doses with Medicine A and Medicine B”. In contrast, married patients and patients who discussed treatment toxicities with a pharmacist or specialist were less likely to indicate that treatment toxicities will affect the likelihood of missing or skipping doses than patients without prior treatment experience. We found no effect of employment on the likelihood that a patient would miss or skip doses. In the second stage of the model, all toxicities had an impact on the likelihood of missing or skipping doses. The effect of each toxicity level on likely adherence is presented in Figure 3. Reducing the severity of congestive heart failure from moderate to mild and reducing the severity of diarrhea from severe to moderate had the largest effect on likely adherence. Reducing the likelihood of serious infection from 12% to 6% had the third largest effect on likely adherence. In contrast, reducing the severity of edema from moderate to mild had the smallest effect on likely adherence.

Bottom Line: Reducing heart failure from moderate to mild and diarrhea from severe to moderate had the largest effects on subjects' evaluation of adherence.Treating or reducing severe toxicities is much more important to patients than treating or reducing moderate toxicities.Focused reductions of certain toxicities may improve treatment adherence.

View Article: PubMed Central - PubMed

Affiliation: RTI Health Solutions, Research Triangle Park, NC, USA;

ABSTRACT

Purpose: To quantify gastrointestinal stromal tumor (GIST) patients' preferences for reducing treatment toxicities and the likely effect of toxicities on patients' stated adherence.

Methods: English-speaking members of the Life Raft Group, a GIST patient advocacy and research organization, aged 18 years and older, completed a web-enabled survey including a series of treatment-choice questions, each presenting a pair of hypothetical GIST medication toxicity profiles. Each profile was defined by common or concerning toxicities verified via pretest interviews including: severity of edema, diarrhea, nausea, fatigue, rash, hand-foot syndrome, and heart failure; and risk of serious infection. Each subject answered 13 choice-format questions based on a predetermined experimental design with known statistical properties. Subjects were asked to rate the likelihood that they would miss or skip doses of medications with different toxicity profiles. Random-parameters logit was used to estimate a relative preference weight for each level of toxicity.

Results: 173 subjects completed the survey. Over the ranges of toxicity levels included in the study, heart failure was the most important toxicity. Edema was the least important. For all toxicities, reducing severity from severe to moderate was more important to subjects than reducing severity from moderate to mild. Reducing heart failure from moderate to mild and diarrhea from severe to moderate had the largest effects on subjects' evaluation of adherence.

Conclusions: All toxicities included in the study are important to patients. Treating or reducing severe toxicities is much more important to patients than treating or reducing moderate toxicities. Focused reductions of certain toxicities may improve treatment adherence.

No MeSH data available.


Related in: MedlinePlus