A discrete choice experiment to assess cancer patients' preferences for when and how to make treatment decisions

Cancer patients can be overwhelmed when being confronted with their diagnosis and treatment options. Such information is often provided during one consultation between the patient and treating clinician. In order to achieve optimal cancer care, there may be justification for alternative consultation styles. We assessed, in a sample of adult medical oncology patients, their preferences for (i) attending one 40-min consultation or two 20-min consultations and (ii) receiving written only or both written and online information, when making a cancer treatment decision.

This was a cross-sectional survey using a discrete choice design of 159 adult medical oncology patients presenting for their second or subsequent outpatient consultation. Participants were presented with a set of hypothetical scenarios and asked to indicate their most and least preferred scenario. The scenarios contained a caveat explaining that there would be no difference between the available treatment options in terms of when treatment would be initiated and the impact it would have on patients' life expectancy.

One hundred forty-seven patients completed the DCE. Of these, 70% (n = 103) preferred being provided with written and online information rather than just written information. This preference was statistically significant (p < 0.01). Fifty-nine percent (n = 86) of patients preferred two 20-min consultations over one 40-min consultation when making a treatment decision. Significantly, more patients preferred two shorter consultations rather than one longer consultation when this was combined with written and online information (p < 0.01).

When making a cancer treatment decision, clinicians should consider offering patients written and online information, combined with two shorter consultations.