Jen Wei-Ying, Yoong Joanne, Liu Xin, Tan Melinda Si Yun, Chng Wee Joo, Chee Yen-Lin
Department of Haematology-Oncology, National University Cancer Institute, Singapore.
Centre for Health Services and Policy Research, Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
Patient Prefer Adherence. 2020 Feb 17;14:301-308. doi: 10.2147/PPA.S241340. eCollection 2020.
The number of treatment options for myeloma and indolent lymphoma are expanding at an exponential rate, with few direct head-to-head comparisons on which to base efficacy measures. We sought to understand how patients, their caregivers and physicians weigh treatment characteristics in order to come to a decision on which treatment option to pursue.
Patients, their caregivers and physicians were recruited and interviewed until data saturation was reached. A qualitative, thematic analysis was done to identify themes important to each stakeholder.
We found that, while all three groups valued efficacy the most, the consideration of other secondary characteristics of the treatment, such as cost, toxicity and logistical issues all differed subtly between the different groups. Patients valued minimising cost and toxicity, even at small trade-offs in efficacy. Caregivers and physicians valued efficacy foremost.
Acknowledging and managing these differences is paramount because they influence shared decision-making and may affect patient outcomes in the short term, as well as their more general well-being in the long term.
骨髓瘤和惰性淋巴瘤的治疗选择数量正在呈指数级增长，可供作为疗效衡量依据的直接头对头比较却很少。我们试图了解患者、其护理人员和医生如何权衡治疗特征，以便决定采用哪种治疗方案。
招募患者、其护理人员和医生并进行访谈，直至达到数据饱和。进行了定性的主题分析，以确定对每个利益相关者重要的主题。
我们发现，虽然所有三组都最看重疗效，但在不同组之间，对治疗的其他次要特征（如成本、毒性和后勤问题）的考虑都存在细微差异。患者重视将成本和毒性降至最低，即使在疗效上有小的权衡。护理人员和医生最看重疗效。
认识并处理这些差异至关重要，因为它们会影响共同决策，可能在短期内影响患者的治疗结果，以及从长期来看他们的总体幸福感。
