Patient treatment preferences study version 1.0
Research type
Research Study
Full title
Understanding patient treatment preferences for muscle invasive bladder cancer: A discrete choice experiment.
IRAS ID
282974
Contact name
Simon Hughes
Contact email
Sponsor organisation
Guy's & St Thomas' NHS Foundation Trust
Duration of Study in the UK
0 years, 10 months, 25 days
Research summary
Summary of Research - Bladder cancer is the 11th most common cancer in the UK (both male and female) yet there is proportionally less research undertaken compared to other types of cancer. Tumours that are just confined to the inner layer are classified as non-muscle invasive bladder cancer (NMIBC), and tumours that progress deeper into the detrusor muscle are classified as muscle invasive bladder cancer (MIBC). At the time of diagnosis for patients approximately 75% are non-muscle invasive and 25% are muscle-invasive/metastatic. MIBCs are often treated with intensive and combined treatments due to their aggressive disease progression and tendency to spread. Current best clinical practice is to offer patients with MIBC a radical cystectomy with lymph node dissection, however not all patients are suitable for surgery, or refuse it. In select cases patients may be offered trimodality therapy, a combination of minor surgery, radiotherapy, and chemotherapy. Through the Patient Treatment Preferences study, we aim to better understand the most important factors for patients when deciding on the type of treatment they receive for MIBC. This will help us improve our knowledge of patient preferences and what “trade-offs” patients are willing to accept. The study consists of a discrete choice experiment (DCE), a type of questionnaire used to elicit preferences in the absence of data.
Summary of Results: We recruited patients with MIBC who had either already completed, were undergoing or had yet to commence radical treatment for MIBC (n = 60). Participants indicated a strong preference for treatments that increased their life expectancy (p = <0.001), had a lower risk of long-term complications (p = <0.001) and less changes to their body image (p = <0.001). Changes to sexual wellbeing (p = 0.09) or an increase in acute side effects (p = 0.99) did not influence preferences. Patients were willing to accept treatments with higher risk of long-term complications to improve their life expectancy or body image.
Conclusion: When deciding on the type of treatment, increased life expectancy is the most important consideration for people with MIBC. The risk of long-term complications and changes to overall body image as a result of treatment are also important. Our study also highlighted that patients are willing to accept a higher risk of long-term complications to improve other treatment outcomes. Understanding patient preferences is important for shared decision-making, which has an impact on quality of care for people living with MIBC.
REC name
South Central - Hampshire A Research Ethics Committee
REC reference
22/SC/0179
Date of REC Opinion
10 Jun 2022
REC opinion
Further Information Favourable Opinion