D Kopasker1, A Kwiatkowski1, R N Matin2, C A Harwood3, F Ismail4, J T Lear5, J Thomson3, Z Hasan3, G N Wali2, A Milligan4, L Crawford6, I Ahmed7, H Duffy7, C M Proby6, P F Allanson1. 1. Economic Studies, School of Business, University of Dundee, Dundee, U.K. 2. Department of Dermatology, Oxford University Hospitals NHS Foundation Trust, Oxford, U.K. 3. Centre for Cell Biology and Cutaneous Research, Barts and The London School of Medicine and Dentistry Blizard Institute, London, U.K. 4. Department of Dermatology, Royal Free Hospital NHS Trust, London, U.K. 5. Manchester Health Science Academic Centre, University of Manchester and Salford Royal NHS Foundation Trust, Manchester, U.K. 6. Division of Cancer Research, School of Medicine, University of Dundee, Dundee, U.K. 7. Cancer Research UK Clinical Trials Unit, University of Birmingham Institute of Cancer and Genomic Sciences, Birmingham, U.K.
Abstract
BACKGROUND: The treatment of actinic keratosis (AK) is a potentially effective strategy for the prevention of cutaneous squamous cell carcinoma (cSCC). However, the patient perspective on potential benefits of AK treatment in terms of skin cancer reduction has received little attention to date. OBJECTIVES: (i) To investigate patient preferences for topical treatments for AK using a discrete-choice experiment (DCE); (ii) to evaluate patient willingness to trade between clinical benefit and medical burden. METHODS: The DCE was conducted as part of a study to establish the feasibility of a phase III randomized controlled trial evaluating the prevention of cSCC using currently available topical interventions. Preferences were elicited by asking patients to make a series of choices between treatment alternatives with different hypothetical combinations of attribute levels. Willingness to trade between treatment attributes was estimated using a flexible-choice model that allows for the heterogeneity of patient preferences. RESULTS: A total of 109 patients with AK completed the DCE. The majority of patients who expressed valid preferences were willing to accept some reduction in both prophylactic and cosmetic efficacy to reduce the burden of the treatment regimen, the severity of skin reaction and other adverse effects. Patients may reject treatment if the perceived therapeutic benefit is outweighed by the subjective burden of treatment. CONCLUSIONS: Evidence of significant variation in the perceived utility of treatments across patients highlights the importance of taking individual patient preferences into account to improve AK treatment acceptability and adherence.
RCT Entities:
BACKGROUND: The treatment of actinic keratosis (AK) is a potentially effective strategy for the prevention of cutaneous squamous cell carcinoma (cSCC). However, the patient perspective on potential benefits of AK treatment in terms of skin cancer reduction has received little attention to date. OBJECTIVES: (i) To investigate patient preferences for topical treatments for AK using a discrete-choice experiment (DCE); (ii) to evaluate patient willingness to trade between clinical benefit and medical burden. METHODS: The DCE was conducted as part of a study to establish the feasibility of a phase III randomized controlled trial evaluating the prevention of cSCC using currently available topical interventions. Preferences were elicited by asking patients to make a series of choices between treatment alternatives with different hypothetical combinations of attribute levels. Willingness to trade between treatment attributes was estimated using a flexible-choice model that allows for the heterogeneity of patient preferences. RESULTS: A total of 109 patients with AK completed the DCE. The majority of patients who expressed valid preferences were willing to accept some reduction in both prophylactic and cosmetic efficacy to reduce the burden of the treatment regimen, the severity of skin reaction and other adverse effects. Patients may reject treatment if the perceived therapeutic benefit is outweighed by the subjective burden of treatment. CONCLUSIONS: Evidence of significant variation in the perceived utility of treatments across patients highlights the importance of taking individual patient preferences into account to improve AK treatment acceptability and adherence.
Authors: E C Noels; M Lugtenberg; S van Egmond; S M Droger; P A J Buis; T Nijsten; M Wakkee Journal: Br J Dermatol Date: 2019-03-15 Impact factor: 9.302
Authors: Zeeshaan-Ul Hasan; Ikhlaaq Ahmed; Rubeta N Matin; Victoria Homer; John T Lear; Ferina Ismail; Tristan Whitmarsh; Adele C Green; Jason Thomson; Alan Milligan; Sarah Hogan; Vanessa Van-de-Velde; Liza Mitchell-Worsford; Jonathan Kentley; Claire Gaunt; Yolande Jefferson-Hulme; Sarah J Bowden; Piers Gaunt; Keith Wheatley; Charlotte M Proby; Catherine A Harwood Journal: Br J Dermatol Date: 2022-06-14 Impact factor: 11.113