Comorbidities can have an impact on what you as a medical professional think is the best course of treatment for your patients. Can they also affect a patient’s thinking on treatment? Comorbidities such as cardiovascular disease, hypertension, and depression can contribute to how a patient’s body responds to treatment and its attendant stress.
A recent study from the Journal of the German Society of Dermatology looked into the question of whether comorbidities play a role in how patients view treatment options based on a number of factors. In this study, 150 patients with melanoma stage IIC to IV participated in a discrete choice experiment to determine what it was they were looking for most in their treatment. Treatment outcomes examined included overall response rate, 2-year survival, progression-free survival, time to response, kind of adverse events, and adverse event-related treatment discontinuation. Preferences for other attributes of the treatment process such as route of administration and frequency of consultations were also studied.
The researchers found that there tended to be a correlation between what outcome or attribute mattered to a patient and what comorbidity they had. Patients who had diabetes, for example, were particularly concerned with adverse effects and frequency of consultations; overall response rate was not as high a priority for them as it was for patients with other comorbidities. Patients with arthropathy also did not prioritize overall response rate, but they cared more about time to response and the route of administration. Those with cardiovascular disease also cared more about time to response and route of administration. Patients with other malignancies identified treatment discontinuation as being of concern. Participating patients with depression assigned greater significance to progression-free survival as a factor of their treatment.
The researchers concluded that comorbidities can have a significant influence on the way patients view possible treatments. It would therefore be beneficial for clinicians to discuss the impact of these conditions on melanoma treatment to better prepare their patients.
Weilandt J, Diehl K, Schaarschmidt M, et al. Patient preferences for treatment of advanced melanoma: impact of comorbidities. JDDG: Journal der Deutschen Dermatologischen Gesellschaft. Published online October 4, 2020. doi:10.1111/ddg.14293