IMPACT OF PATIENT INVOLVEMENT IN TREATMENT DECISION-MAKING ON HEALTH-RELATED QUALITY OF LIFE (HRQOL) IN METASTATIC UROTHELIAL CANCER (MUC): RESULTS OF A CROSS-SECTIONAL, REAL-WORLD SURVEY IN EUROPE AND THE US
Author(s)
Mairead M. Kearney, MBA, MPH, MSc, MD1, Mia Unsworth, BSc Hons2, Cameron Forshaw, MSc2, Maria Walley, MSc2, Hannah Wear, MSc2, Amber Simpson, BSc2, Alastair Hinds, BSc2, Imun Gill, MPharm3, Syed A. Hussain, MBBS, MSC, MD, FRCP4.
1Merck Healthcare KGaA, Darmstadt, Germany, 2Adelphi Real World, Bollington, United Kingdom, 3Merck Serono Ltd., an affiliate of Merck KGaA, Feltham, United Kingdom, 4Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, United Kingdom.
1Merck Healthcare KGaA, Darmstadt, Germany, 2Adelphi Real World, Bollington, United Kingdom, 3Merck Serono Ltd., an affiliate of Merck KGaA, Feltham, United Kingdom, 4Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, United Kingdom.
OBJECTIVES: Recent approvals for mUC have increased the complexity of the treatment decision-making process. In other types of cancer, active patient involvement in the decision-making process has been associated with better HRQOL. Shared decision-making (SDM) helps improve outcomes at the individual patient basis. Patients are keen to focus on quality of living rather than just quantity of living. This study quantified patient involvement and assessed associations with HRQOL among patients with mUC.
METHODS: Data were drawn from the Adelphi Real World mUC Disease Specific Programme™, a multinational (EU5, US), cross-sectional survey of medical oncologists/urologists and their patients with mUC from December 2023-July 2024. Physicians reported patient demographics. Patients voluntarily reported their involvement in the treatment decision and completed the EQ-5D-5L and EORTC QLQ-C30. Health status using the EQ-5D-5L (German tariff) and EORTC QLQ-C30 scores were compared between involved and noninvolved patients using entropy balancing to adjust for age, caregiver status, ECOG performance status, symptoms, concomitant conditions, and presence of visceral metastases.
RESULTS: Of 309 patients, 77% were ≥65 years and 71% were male; 59 (19%) reported being involved in their treatment decision. No statistically significant difference was found between EQ-5D-5L adjusted mean scores for patients involved and not involved (0.76 vs 0.73; p=0.361) or for adjusted mean EORTC QLQ-C30 global health status scores (50.14 vs 49.85; p=0.905). Better role functioning (61.58 vs 50.80; p=0.019) and lower fatigue (34.84 vs 45.02; p=0.005) were observed in the respective EORTC QLQ-C30 domains for patients involved vs not involved; no other domains showed statistically significant differences.
CONCLUSIONS: SDM, an area of research interest and unmet need, was underutilized in this population. While global HRQOL was comparable, SDM was associated with better role functioning/lower fatigue, suggesting potential HRQOL benefits from patient involvement in treatment selection. Greater implementation of SDM may help optimize patient-centered care and HRQOL outcomes in mUC.
METHODS: Data were drawn from the Adelphi Real World mUC Disease Specific Programme™, a multinational (EU5, US), cross-sectional survey of medical oncologists/urologists and their patients with mUC from December 2023-July 2024. Physicians reported patient demographics. Patients voluntarily reported their involvement in the treatment decision and completed the EQ-5D-5L and EORTC QLQ-C30. Health status using the EQ-5D-5L (German tariff) and EORTC QLQ-C30 scores were compared between involved and noninvolved patients using entropy balancing to adjust for age, caregiver status, ECOG performance status, symptoms, concomitant conditions, and presence of visceral metastases.
RESULTS: Of 309 patients, 77% were ≥65 years and 71% were male; 59 (19%) reported being involved in their treatment decision. No statistically significant difference was found between EQ-5D-5L adjusted mean scores for patients involved and not involved (0.76 vs 0.73; p=0.361) or for adjusted mean EORTC QLQ-C30 global health status scores (50.14 vs 49.85; p=0.905). Better role functioning (61.58 vs 50.80; p=0.019) and lower fatigue (34.84 vs 45.02; p=0.005) were observed in the respective EORTC QLQ-C30 domains for patients involved vs not involved; no other domains showed statistically significant differences.
CONCLUSIONS: SDM, an area of research interest and unmet need, was underutilized in this population. While global HRQOL was comparable, SDM was associated with better role functioning/lower fatigue, suggesting potential HRQOL benefits from patient involvement in treatment selection. Greater implementation of SDM may help optimize patient-centered care and HRQOL outcomes in mUC.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
PCR26
Topic
Patient-Centered Research
Topic Subcategory
Patient Engagement, Patient-reported Outcomes & Quality of Life Outcomes
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology