Quantifying treatment preferences and their association with financial toxicity in women with breast cancer
Background The objective of the current study was to understand treatment preferences and their association with financial toxicity in Patient Advocate Foundation clients with breast cancer. Methods This choice‐based conjoint analysis used data from a nationwide sample of women with breast cancer wh...
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| Veröffentlicht in: | Cancer 2021-02, Vol.127 (3), p.449-457 |
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| container_title | Cancer |
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| creator | Williams, Courtney P. Gallagher, Kathleen D. Deehr, Katie Aswani, Monica S. Azuero, Andres Daniel, Casey L. Ford, Eric W. Ingram, Stacey A. Balch, Alan J. Rocque, Gabrielle B. |
| description | Background
The objective of the current study was to understand treatment preferences and their association with financial toxicity in Patient Advocate Foundation clients with breast cancer.
Methods
This choice‐based conjoint analysis used data from a nationwide sample of women with breast cancer who received assistance from the Patient Advocate Foundation. Choice sets created from 13 attributes of 3 levels each elicited patient preferences and trade‐offs. Latent class analysis segmented respondents into distinct preference archetypes. The Comprehensive Score for Financial Toxicity (COST) tool captured financial toxicity. Adjusted generalized linear models estimated COST score differences by preference archetype.
Results
Of 220 respondents (for a response rate of 10%), the median age was 58 years (interquartile range, 49‐66 years); 28% of respondents were Black, indigenous, or people of color; and approximately 60% had household incomes |
| doi_str_mv | 10.1002/cncr.33287 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2454652952</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2454652952</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3937-3f2ece369abb8bf362df8cfec67846e655b5ecc829b8606fe1422e49e7ee0f063</originalsourceid><addsrcrecordid>eNp90U1LBCEYB3CJot1eLn2AELpEMOXo6DjHWHqDKIqCboPjPrbWrLOpw7bfPmuqQ4dOov74o88fob2cHOeE0BPttD9mjMpyDY1zUpUZyQu6jsaEEJnxgj2N0FYIL2lbUs420YixnEhC2Ri93vXKRWtW1j3j6EHFObiIFx4MeHAaAlZuiuMMrMcqhE5bFW3n8NLGGTbWKZdOWhy7d6ttXGGbrrqUMYAmJYaIdVLgd9CGUW2A3e91Gz2enz1MLrPr24uryel1plnFyowZChqYqFTTyMYwQadGagNalLIQIDhvOGgtadVIQYSB9FkKRQUlADFEsG10OOQufPfWQ4j13AYNbascdH2oacELwWnFaaIHf-hL13uXXpdUKSSvqCBJHQ1K-y6ENJp64e1c-VWdk_qzgvqzgvqrgoT3vyP7Zg7TX_oz8wTyASxtC6t_ourJzeR-CP0A9p6TJw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2476859260</pqid></control><display><type>article</type><title>Quantifying treatment preferences and their association with financial toxicity in women with breast cancer</title><source>Wiley Free Content</source><source>Wiley Online Library Journals Frontfile Complete</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><creator>Williams, Courtney P. ; Gallagher, Kathleen D. ; Deehr, Katie ; Aswani, Monica S. ; Azuero, Andres ; Daniel, Casey L. ; Ford, Eric W. ; Ingram, Stacey A. ; Balch, Alan J. ; Rocque, Gabrielle B.</creator><creatorcontrib>Williams, Courtney P. ; Gallagher, Kathleen D. ; Deehr, Katie ; Aswani, Monica S. ; Azuero, Andres ; Daniel, Casey L. ; Ford, Eric W. ; Ingram, Stacey A. ; Balch, Alan J. ; Rocque, Gabrielle B.</creatorcontrib><description>Background
The objective of the current study was to understand treatment preferences and their association with financial toxicity in Patient Advocate Foundation clients with breast cancer.
Methods
This choice‐based conjoint analysis used data from a nationwide sample of women with breast cancer who received assistance from the Patient Advocate Foundation. Choice sets created from 13 attributes of 3 levels each elicited patient preferences and trade‐offs. Latent class analysis segmented respondents into distinct preference archetypes. The Comprehensive Score for Financial Toxicity (COST) tool captured financial toxicity. Adjusted generalized linear models estimated COST score differences by preference archetype.
Results
Of 220 respondents (for a response rate of 10%), the median age was 58 years (interquartile range, 49‐66 years); 28% of respondents were Black, indigenous, or people of color; and approximately 60% had household incomes <$40,000. The majority of respondents were diagnosed with early‐stage cancer (91%), 38% had recurrent disease, and 61% were receiving treatment. Treatment choice was most affected by preferences related to affordability and impact on activities of daily living. Two distinct treatment preference archetypes emerged. The “cost‐prioritizing group” (75% of respondents) was most concerned about affordability, impact on activities of daily living, and burdening care partners. The “functional independence–prioritizing group” (25% of respondents) was most concerned about their ability to work, physical side effects, and interference with life events. COST scores were found to be similar between the archetypes in adjusted models (cost‐prioritizing group COST score, 12 [95% confidence interval, 9‐14]; and functional independence–prioritizing COST score, 11 [95% confidence interval, 9‐13]).
Conclusions
Patients with breast cancer prioritized affordability or maintaining functional independence when making treatment decisions. Because of this variability, preference evaluation during treatment decision making could optimize patients' treatment experiences.
In a sample of underresourced patients with breast cancer, treatment affordability or maintaining functional independence in everyday life is found to be most prioritized when making treatment decisions. Financial toxicity is common and severe but does not appear to differ between patients with differing preferences.</description><identifier>ISSN: 0008-543X</identifier><identifier>EISSN: 1097-0142</identifier><identifier>DOI: 10.1002/cncr.33287</identifier><identifier>PMID: 33108023</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Activities of daily living ; Breast cancer ; choice‐based conjoint ; Confidence intervals ; Decision making ; financial toxicity ; Generalized linear models ; Latent class analysis ; Medical treatment ; Oncology ; patient advocacy foundations ; Preferences ; Side effects ; Statistical models ; Toxicity ; treatment preferences</subject><ispartof>Cancer, 2021-02, Vol.127 (3), p.449-457</ispartof><rights>2020 American Cancer Society</rights><rights>2020 American Cancer Society.</rights><rights>2021 American Cancer Society</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3937-3f2ece369abb8bf362df8cfec67846e655b5ecc829b8606fe1422e49e7ee0f063</citedby><cites>FETCH-LOGICAL-c3937-3f2ece369abb8bf362df8cfec67846e655b5ecc829b8606fe1422e49e7ee0f063</cites><orcidid>0000-0003-3315-8720 ; 0000-0003-4188-9785 ; 0000-0001-5328-7517</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fcncr.33287$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fcncr.33287$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33108023$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Williams, Courtney P.</creatorcontrib><creatorcontrib>Gallagher, Kathleen D.</creatorcontrib><creatorcontrib>Deehr, Katie</creatorcontrib><creatorcontrib>Aswani, Monica S.</creatorcontrib><creatorcontrib>Azuero, Andres</creatorcontrib><creatorcontrib>Daniel, Casey L.</creatorcontrib><creatorcontrib>Ford, Eric W.</creatorcontrib><creatorcontrib>Ingram, Stacey A.</creatorcontrib><creatorcontrib>Balch, Alan J.</creatorcontrib><creatorcontrib>Rocque, Gabrielle B.</creatorcontrib><title>Quantifying treatment preferences and their association with financial toxicity in women with breast cancer</title><title>Cancer</title><addtitle>Cancer</addtitle><description>Background
The objective of the current study was to understand treatment preferences and their association with financial toxicity in Patient Advocate Foundation clients with breast cancer.
Methods
This choice‐based conjoint analysis used data from a nationwide sample of women with breast cancer who received assistance from the Patient Advocate Foundation. Choice sets created from 13 attributes of 3 levels each elicited patient preferences and trade‐offs. Latent class analysis segmented respondents into distinct preference archetypes. The Comprehensive Score for Financial Toxicity (COST) tool captured financial toxicity. Adjusted generalized linear models estimated COST score differences by preference archetype.
Results
Of 220 respondents (for a response rate of 10%), the median age was 58 years (interquartile range, 49‐66 years); 28% of respondents were Black, indigenous, or people of color; and approximately 60% had household incomes <$40,000. The majority of respondents were diagnosed with early‐stage cancer (91%), 38% had recurrent disease, and 61% were receiving treatment. Treatment choice was most affected by preferences related to affordability and impact on activities of daily living. Two distinct treatment preference archetypes emerged. The “cost‐prioritizing group” (75% of respondents) was most concerned about affordability, impact on activities of daily living, and burdening care partners. The “functional independence–prioritizing group” (25% of respondents) was most concerned about their ability to work, physical side effects, and interference with life events. COST scores were found to be similar between the archetypes in adjusted models (cost‐prioritizing group COST score, 12 [95% confidence interval, 9‐14]; and functional independence–prioritizing COST score, 11 [95% confidence interval, 9‐13]).
Conclusions
Patients with breast cancer prioritized affordability or maintaining functional independence when making treatment decisions. Because of this variability, preference evaluation during treatment decision making could optimize patients' treatment experiences.
In a sample of underresourced patients with breast cancer, treatment affordability or maintaining functional independence in everyday life is found to be most prioritized when making treatment decisions. Financial toxicity is common and severe but does not appear to differ between patients with differing preferences.</description><subject>Activities of daily living</subject><subject>Breast cancer</subject><subject>choice‐based conjoint</subject><subject>Confidence intervals</subject><subject>Decision making</subject><subject>financial toxicity</subject><subject>Generalized linear models</subject><subject>Latent class analysis</subject><subject>Medical treatment</subject><subject>Oncology</subject><subject>patient advocacy foundations</subject><subject>Preferences</subject><subject>Side effects</subject><subject>Statistical models</subject><subject>Toxicity</subject><subject>treatment preferences</subject><issn>0008-543X</issn><issn>1097-0142</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp90U1LBCEYB3CJot1eLn2AELpEMOXo6DjHWHqDKIqCboPjPrbWrLOpw7bfPmuqQ4dOov74o88fob2cHOeE0BPttD9mjMpyDY1zUpUZyQu6jsaEEJnxgj2N0FYIL2lbUs420YixnEhC2Ri93vXKRWtW1j3j6EHFObiIFx4MeHAaAlZuiuMMrMcqhE5bFW3n8NLGGTbWKZdOWhy7d6ttXGGbrrqUMYAmJYaIdVLgd9CGUW2A3e91Gz2enz1MLrPr24uryel1plnFyowZChqYqFTTyMYwQadGagNalLIQIDhvOGgtadVIQYSB9FkKRQUlADFEsG10OOQufPfWQ4j13AYNbascdH2oacELwWnFaaIHf-hL13uXXpdUKSSvqCBJHQ1K-y6ENJp64e1c-VWdk_qzgvqzgvqrgoT3vyP7Zg7TX_oz8wTyASxtC6t_ourJzeR-CP0A9p6TJw</recordid><startdate>20210201</startdate><enddate>20210201</enddate><creator>Williams, Courtney P.</creator><creator>Gallagher, Kathleen D.</creator><creator>Deehr, Katie</creator><creator>Aswani, Monica S.</creator><creator>Azuero, Andres</creator><creator>Daniel, Casey L.</creator><creator>Ford, Eric W.</creator><creator>Ingram, Stacey A.</creator><creator>Balch, Alan J.</creator><creator>Rocque, Gabrielle B.</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TO</scope><scope>7U7</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3315-8720</orcidid><orcidid>https://orcid.org/0000-0003-4188-9785</orcidid><orcidid>https://orcid.org/0000-0001-5328-7517</orcidid></search><sort><creationdate>20210201</creationdate><title>Quantifying treatment preferences and their association with financial toxicity in women with breast cancer</title><author>Williams, Courtney P. ; Gallagher, Kathleen D. ; Deehr, Katie ; Aswani, Monica S. ; Azuero, Andres ; Daniel, Casey L. ; Ford, Eric W. ; Ingram, Stacey A. ; Balch, Alan J. ; Rocque, Gabrielle B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3937-3f2ece369abb8bf362df8cfec67846e655b5ecc829b8606fe1422e49e7ee0f063</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Activities of daily living</topic><topic>Breast cancer</topic><topic>choice‐based conjoint</topic><topic>Confidence intervals</topic><topic>Decision making</topic><topic>financial toxicity</topic><topic>Generalized linear models</topic><topic>Latent class analysis</topic><topic>Medical treatment</topic><topic>Oncology</topic><topic>patient advocacy foundations</topic><topic>Preferences</topic><topic>Side effects</topic><topic>Statistical models</topic><topic>Toxicity</topic><topic>treatment preferences</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Williams, Courtney P.</creatorcontrib><creatorcontrib>Gallagher, Kathleen D.</creatorcontrib><creatorcontrib>Deehr, Katie</creatorcontrib><creatorcontrib>Aswani, Monica S.</creatorcontrib><creatorcontrib>Azuero, Andres</creatorcontrib><creatorcontrib>Daniel, Casey L.</creatorcontrib><creatorcontrib>Ford, Eric W.</creatorcontrib><creatorcontrib>Ingram, Stacey A.</creatorcontrib><creatorcontrib>Balch, Alan J.</creatorcontrib><creatorcontrib>Rocque, Gabrielle B.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Williams, Courtney P.</au><au>Gallagher, Kathleen D.</au><au>Deehr, Katie</au><au>Aswani, Monica S.</au><au>Azuero, Andres</au><au>Daniel, Casey L.</au><au>Ford, Eric W.</au><au>Ingram, Stacey A.</au><au>Balch, Alan J.</au><au>Rocque, Gabrielle B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Quantifying treatment preferences and their association with financial toxicity in women with breast cancer</atitle><jtitle>Cancer</jtitle><addtitle>Cancer</addtitle><date>2021-02-01</date><risdate>2021</risdate><volume>127</volume><issue>3</issue><spage>449</spage><epage>457</epage><pages>449-457</pages><issn>0008-543X</issn><eissn>1097-0142</eissn><abstract>Background
The objective of the current study was to understand treatment preferences and their association with financial toxicity in Patient Advocate Foundation clients with breast cancer.
Methods
This choice‐based conjoint analysis used data from a nationwide sample of women with breast cancer who received assistance from the Patient Advocate Foundation. Choice sets created from 13 attributes of 3 levels each elicited patient preferences and trade‐offs. Latent class analysis segmented respondents into distinct preference archetypes. The Comprehensive Score for Financial Toxicity (COST) tool captured financial toxicity. Adjusted generalized linear models estimated COST score differences by preference archetype.
Results
Of 220 respondents (for a response rate of 10%), the median age was 58 years (interquartile range, 49‐66 years); 28% of respondents were Black, indigenous, or people of color; and approximately 60% had household incomes <$40,000. The majority of respondents were diagnosed with early‐stage cancer (91%), 38% had recurrent disease, and 61% were receiving treatment. Treatment choice was most affected by preferences related to affordability and impact on activities of daily living. Two distinct treatment preference archetypes emerged. The “cost‐prioritizing group” (75% of respondents) was most concerned about affordability, impact on activities of daily living, and burdening care partners. The “functional independence–prioritizing group” (25% of respondents) was most concerned about their ability to work, physical side effects, and interference with life events. COST scores were found to be similar between the archetypes in adjusted models (cost‐prioritizing group COST score, 12 [95% confidence interval, 9‐14]; and functional independence–prioritizing COST score, 11 [95% confidence interval, 9‐13]).
Conclusions
Patients with breast cancer prioritized affordability or maintaining functional independence when making treatment decisions. Because of this variability, preference evaluation during treatment decision making could optimize patients' treatment experiences.
In a sample of underresourced patients with breast cancer, treatment affordability or maintaining functional independence in everyday life is found to be most prioritized when making treatment decisions. Financial toxicity is common and severe but does not appear to differ between patients with differing preferences.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>33108023</pmid><doi>10.1002/cncr.33287</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-3315-8720</orcidid><orcidid>https://orcid.org/0000-0003-4188-9785</orcidid><orcidid>https://orcid.org/0000-0001-5328-7517</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Activities of daily living Breast cancer choice‐based conjoint Confidence intervals Decision making financial toxicity Generalized linear models Latent class analysis Medical treatment Oncology patient advocacy foundations Preferences Side effects Statistical models Toxicity treatment preferences |
| title | Quantifying treatment preferences and their association with financial toxicity in women with breast cancer |
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