Patients’ and physicians’ preferences don’t always align

2020-04-06

Despite having a joint objective, patients' and physicians' preferences for treatment options sometimes differ. Patients are more inclined to want acute symptoms reduced, whereas physicians are looking for treatment options that offer more long-term disease management. A recent publication from Novartis examines physicians’ preferences for treating patients with liver disease, more specifically non-alcoholic steatohepatitis.

This study is one of several published studies conducted by members of the PREFER consortium that are outside the scope of the project but will help answer questions addressed by PREFER. In this case, exploring the preferences and characteristics relevant to physician decision-making when choosing a potential therapy for patients and comparing them with patient preferences. 

Both physicians who treat non-alcoholic steatohepatitis (NASH) and patients that live with NASH prefer treatments that can significantly improve liver health. But when they were asked to choose between treatments with the same ability to improve liver health, their secondary priorities turned out to be different. 

“Physicians rated the impact on the ‘progression to cirrhosis’, long-term liver damage, as similarly important to improving liver health. This longer-term treatment benefit was rated much lower by patients. Instead, patients appear to give more weight to the impact on symptoms related to their liver disease and more immediate quality of life measures,” says Nigel Cook, one of the authors. 

In this first study ever of physician preferences for treating NASH, it becomes evident that the treatment profiles patients would most prefer are not always the same as that of their treating physicians. 

When making benefit-risk tradeoffs, and deciding on the best future treatment option for a patient, the patient-physician communication is key to ensure a shared perspective and that both parties are aware of the near-term and longer-term benefits of treatment options. 

By Anna Holm

Cook N, Geier A, Schmid A, Hirschfield G, Kautz A, Schattenberg JM, Balp MM, Assessing physician preferences on future therapeutic options and diagnostic practices in non-alcoholic steatohepatitis, JHEP Reports, 2020; 2; 2

Cook N, Balp M.M, Geier A, Schmid A, Hirschfield G, Kautz A, et al, The patient perspectives on future therapeutic options in NASH and patient needs, Front Med, 2019; 6: 61