Exploring the Role of Patient Preferences in Hepatocellular Carcinoma Treatment Decisions: A Qualitative Study

Background. Hepatocellular carcinoma (HCC) treatment decisions are becoming increasingly complex as new treatment options emerge. Improved understanding of tradeoffs and patient preferences in treatment decisions will enhance patient–provider discussions, improve treatment development, and inform HC...

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Main Authors: Andrew M. Moon, Daniel Richardson, Gabriel V. Lupu, Donna M. Evon, Hanna K. Sanoff, Jessica Carda-Auten, Randall Teal, Myra Waheed, Ethan Basch, David M. Mauro, Ted K. Yanagihara, David A. Gerber, Neil D. Shah, Oren K. Fix, Hersh Shroff, Tammy Triglianos, Jonathan D. Sorah, Jingquan Jia, Ashwin Somasundaram, Lynne I. Wagner, Michael D. Kappelman, Matthew Schooler, Julia R. Phillips, Hiwot A. Ekuban, Ariel E. Sanderford, A. Sidney Barritt
Format: Article
Language:English
Published: SAGE Publishing 2025-05-01
Series:MDM Policy & Practice
Online Access:https://doi.org/10.1177/23814683251340055
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author Andrew M. Moon
Daniel Richardson
Gabriel V. Lupu
Donna M. Evon
Hanna K. Sanoff
Jessica Carda-Auten
Randall Teal
Myra Waheed
Ethan Basch
David M. Mauro
Ted K. Yanagihara
David A. Gerber
Neil D. Shah
Oren K. Fix
Hersh Shroff
Tammy Triglianos
Jonathan D. Sorah
Jingquan Jia
Ashwin Somasundaram
Lynne I. Wagner
Michael D. Kappelman
Matthew Schooler
Julia R. Phillips
Hiwot A. Ekuban
Ariel E. Sanderford
A. Sidney Barritt
author_facet Andrew M. Moon
Daniel Richardson
Gabriel V. Lupu
Donna M. Evon
Hanna K. Sanoff
Jessica Carda-Auten
Randall Teal
Myra Waheed
Ethan Basch
David M. Mauro
Ted K. Yanagihara
David A. Gerber
Neil D. Shah
Oren K. Fix
Hersh Shroff
Tammy Triglianos
Jonathan D. Sorah
Jingquan Jia
Ashwin Somasundaram
Lynne I. Wagner
Michael D. Kappelman
Matthew Schooler
Julia R. Phillips
Hiwot A. Ekuban
Ariel E. Sanderford
A. Sidney Barritt
author_sort Andrew M. Moon
collection DOAJ
description Background. Hepatocellular carcinoma (HCC) treatment decisions are becoming increasingly complex as new treatment options emerge. Improved understanding of tradeoffs and patient preferences in treatment decisions will enhance patient–provider discussions, improve treatment development, and inform HCC treatment guidelines. We performed a qualitative study involving patients with HCC and medical providers to assess the role of patient preferences in HCC treatment choices. Methods. Patient participants included those with HCC seen within a single tertiary care center. Provider participants involved physicians and advanced practice providers who cared for patients with HCC from a single center. Baseline and posttreatment patient interviews were conducted by trained qualitative research experts, informed by semi-structured interview guides, and analyzed using thematic analysis with pilot-tested codebooks. Summaries included a narrative description of the themes and subthemes that emerged related to each code, and illustrative quotes were used to highlight each theme. Results. The baseline interview involved 30 patients with HCC (22 of whom participated in follow-up interviews) and 10 providers who cared for patients with HCC. Patients identified factors considered when making treatment decisions included provider confidence and experience, patient prior cancer experiences, other health issues, and faith. Providers primarily discussed the role of Barcelona Clinic Liver Cancer stage, liver function, performance status, and eligibility of liver transplantation in making treatment recommendations. There was general agreement among providers that there is a need to better understand the role of patient values to improve care for HCC. Limitations. Qualitative interviews were limited to patients and providers from a single center. Conclusions. This qualitative study provided information on the variety of values considered by both patients and providers in HCC treatment decisions and the importance of considering tradeoffs of efficacy, toxicity, and inconvenience/costs. Highlights Hepatocellular carcinoma (HCC) treatment decisions are often complex and may become increasingly so as new treatment options emerge. Improved understanding of tradeoffs and patient preferences in treatment decisions will enhance patient–provider discussions, facilitate patient-centered trials to develop new treatments, and inform HCC treatment guidelines. This qualitative study of patients and providers provided information on the values considered in HCC treatment decisions and the importance of considering the tradeoffs of efficacy, toxicity, and inconvenience/costs. These insights can be used to develop preference elicitation tools, perform large-scale preference elicitation surveys, and systematically assess and incorporate patient preferences into treatment decisions.
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spelling doaj-art-ce2734bc27f549ea9471a7fdcff2227b2025-08-20T02:17:01ZengSAGE PublishingMDM Policy & Practice2381-46832025-05-011010.1177/23814683251340055Exploring the Role of Patient Preferences in Hepatocellular Carcinoma Treatment Decisions: A Qualitative StudyAndrew M. MoonDaniel RichardsonGabriel V. LupuDonna M. EvonHanna K. SanoffJessica Carda-AutenRandall TealMyra WaheedEthan BaschDavid M. MauroTed K. YanagiharaDavid A. GerberNeil D. ShahOren K. FixHersh ShroffTammy TriglianosJonathan D. SorahJingquan JiaAshwin SomasundaramLynne I. WagnerMichael D. KappelmanMatthew SchoolerJulia R. PhillipsHiwot A. EkubanAriel E. SanderfordA. Sidney BarrittBackground. Hepatocellular carcinoma (HCC) treatment decisions are becoming increasingly complex as new treatment options emerge. Improved understanding of tradeoffs and patient preferences in treatment decisions will enhance patient–provider discussions, improve treatment development, and inform HCC treatment guidelines. We performed a qualitative study involving patients with HCC and medical providers to assess the role of patient preferences in HCC treatment choices. Methods. Patient participants included those with HCC seen within a single tertiary care center. Provider participants involved physicians and advanced practice providers who cared for patients with HCC from a single center. Baseline and posttreatment patient interviews were conducted by trained qualitative research experts, informed by semi-structured interview guides, and analyzed using thematic analysis with pilot-tested codebooks. Summaries included a narrative description of the themes and subthemes that emerged related to each code, and illustrative quotes were used to highlight each theme. Results. The baseline interview involved 30 patients with HCC (22 of whom participated in follow-up interviews) and 10 providers who cared for patients with HCC. Patients identified factors considered when making treatment decisions included provider confidence and experience, patient prior cancer experiences, other health issues, and faith. Providers primarily discussed the role of Barcelona Clinic Liver Cancer stage, liver function, performance status, and eligibility of liver transplantation in making treatment recommendations. There was general agreement among providers that there is a need to better understand the role of patient values to improve care for HCC. Limitations. Qualitative interviews were limited to patients and providers from a single center. Conclusions. This qualitative study provided information on the variety of values considered by both patients and providers in HCC treatment decisions and the importance of considering tradeoffs of efficacy, toxicity, and inconvenience/costs. Highlights Hepatocellular carcinoma (HCC) treatment decisions are often complex and may become increasingly so as new treatment options emerge. Improved understanding of tradeoffs and patient preferences in treatment decisions will enhance patient–provider discussions, facilitate patient-centered trials to develop new treatments, and inform HCC treatment guidelines. This qualitative study of patients and providers provided information on the values considered in HCC treatment decisions and the importance of considering the tradeoffs of efficacy, toxicity, and inconvenience/costs. These insights can be used to develop preference elicitation tools, perform large-scale preference elicitation surveys, and systematically assess and incorporate patient preferences into treatment decisions.https://doi.org/10.1177/23814683251340055
spellingShingle Andrew M. Moon
Daniel Richardson
Gabriel V. Lupu
Donna M. Evon
Hanna K. Sanoff
Jessica Carda-Auten
Randall Teal
Myra Waheed
Ethan Basch
David M. Mauro
Ted K. Yanagihara
David A. Gerber
Neil D. Shah
Oren K. Fix
Hersh Shroff
Tammy Triglianos
Jonathan D. Sorah
Jingquan Jia
Ashwin Somasundaram
Lynne I. Wagner
Michael D. Kappelman
Matthew Schooler
Julia R. Phillips
Hiwot A. Ekuban
Ariel E. Sanderford
A. Sidney Barritt
Exploring the Role of Patient Preferences in Hepatocellular Carcinoma Treatment Decisions: A Qualitative Study
MDM Policy & Practice
title Exploring the Role of Patient Preferences in Hepatocellular Carcinoma Treatment Decisions: A Qualitative Study
title_full Exploring the Role of Patient Preferences in Hepatocellular Carcinoma Treatment Decisions: A Qualitative Study
title_fullStr Exploring the Role of Patient Preferences in Hepatocellular Carcinoma Treatment Decisions: A Qualitative Study
title_full_unstemmed Exploring the Role of Patient Preferences in Hepatocellular Carcinoma Treatment Decisions: A Qualitative Study
title_short Exploring the Role of Patient Preferences in Hepatocellular Carcinoma Treatment Decisions: A Qualitative Study
title_sort exploring the role of patient preferences in hepatocellular carcinoma treatment decisions a qualitative study
url https://doi.org/10.1177/23814683251340055
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