Patient Preferences for Breast Cancer Treatment Interventions: A Systematic Review of Discrete Choice Experiments

Renata Leborato Guerra (), Luciana Castaneda, Rita de Cássia Ribeiro Albuquerque, Camila Belo Tavares Ferreira, Flávia de Miranda Corrêa, Ricardo Ribeiro Alves Fernandes and Liz Maria Almeida
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Renata Leborato Guerra: Health Technology Assessment Unit of the Brazilian National Institute of Cancer
Luciana Castaneda: Health Technology Assessment Unit of the Brazilian National Institute of Cancer
Rita de Cássia Ribeiro Albuquerque: Health Technology Assessment Unit of the Brazilian National Institute of Cancer
Camila Belo Tavares Ferreira: Teaching Coordination of the Brazilian National Cancer Institute
Flávia de Miranda Corrêa: Health Technology Assessment Unit of the Brazilian National Institute of Cancer
Ricardo Ribeiro Alves Fernandes: Health Technology Assessment Unit of the Brazilian National Institute of Cancer
Liz Maria Almeida: Populational Research Division of the Brazilian National Institute of Cancer

The Patient: Patient-Centered Outcomes Research, 2019, vol. 12, issue 6, No 3, 559-569

Abstract: Abstract Introduction Understanding how patients value different characteristics of an intervention and make trade-offs in a therapy choice context with potential benefit and possible harm may result in decisions for which a better reflected value is delivered. This systematic review summarizes patient preferences for breast cancer treatments elicited by discrete choice experiments (DCE). Methodology The electronic databases MEDLINE (PubMed), Scopus, PsycINFO, CINAHL, LILACS, and Web of Science were last searched on May 9, 2019 without restrictions regarding language and time of publication. Original studies reporting patient preferences related to breast cancer treatment (surgery, radiotherapy, endocrine therapy, chemotherapy or palliative care) elicited by DCE were eligible. A narrative synthesis of the relative importance and trade-offs of the treatment attributes of each study was reported. Results Five studies conducted in Japan, Thailand, USA and the Netherlands with 146–298 participants evaluated preferences regarding chemotherapy regimens for advanced/metastatic disease, and breast reconstruction after mastectomy. The attributes with major relative effects on preferences were greater survival, better aesthetic result of the surgery, and lower side effects and complication rates. Patients would trade a better aesthetic result to minimize complication rates, and, in advanced disease, the willingness to pay was greater for gains in survival and to avoid some severe adverse events. Conclusion Despite the relative lack of evidence in this specific context, our review shows that breast cancer patients naturally value greater benefit and, in scenarios of advanced and metastatic disease, are willing to face risks of some side effects for gains in survival.

Date: 2019
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DOI: 10.1007/s40271-019-00375-w

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