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

Morgan, J.L.; Walters, S.J.; Collins, K.; Robinson, T.G.; Cheung, Kwok-Leung; Audisio, R.; Reed, M.W.; Wyld, L.

Authors

J.L. Morgan

S.J. Walters

K. Collins

T.G. Robinson

R. Audisio

M.W. Reed

L. Wyld



Abstract

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.

Journal Article Type Article
Publication Date Jul 1, 2017
Journal European Journal of Surgical Oncology (EJSO)
Electronic ISSN 0748-7983
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 43
Issue 7
APA6 Citation Morgan, J., Walters, S., Collins, K., Robinson, T., Cheung, K., Audisio, R., …Wyld, L. (2017). What influences healthcare professionals' treatment preferences for older women with operable breast cancer?: an application of the discrete choice experiment. EJSO - European Journal of Surgical Oncology, 43(7), https://doi.org/10.1016/j.ejso.2017.01.012
DOI https://doi.org/10.1016/j.ejso.2017.01.012
Keywords Breast cancer; Primary endocrine therapy; Surgery; Discrete choice experiment; Older
Publisher URL http://www.sciencedirect.com/science/article/pii/S0748798317301075
Copyright Statement Copyright information regarding this work can be found at the following address: http://eprints.nottingh.../end_user_agreement.pdf

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MORGAN HCP decision preferences for EPC Revised manuscript for EJSO version 2 2017.pdf (438 Kb)
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Copyright Statement
Copyright information regarding this work can be found at the following address: http://eprints.nottingham.ac.uk/end_user_agreement.pdf





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