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case studies

Using real-world evidence to drive shared decision-making for patients with Relapsed or Refractory Diffuse Large B Cell Lymphoma

11/29/2023

Generating real-world evidence to improve shared decision-making among patients and providers.

Client

A leading life sciences company

 

Name of service provided

Patient-Centered Outcomes

 

Situation

Patients with Relapsed or Refractory Diffuse Large B Cell Lymphoma (R/R DLBCL) face complex decisions when selecting treatment options, especially if first-line treatment fails. Shared decision-making (i.e., collaboration between patients and providers to evaluate the tradeoffs of treatment options and select the option that best reflects patient priorities and preferences) could improve second- and third-line treatment selection for these patients. However, a lack of real-world evidence (RWE) on the priorities and preferences of these patients has limited the use of shared decision-making in second- and third-line R/R DLBCL treatment selections.

We partnered with a major life sciences company to conduct interviews on treatment priorities and preferences with patients, providers, and caregivers dealing with R/R DLBCL.

 

Solution

We characterized the RWE gap by conducting a targeted literature review, created a semi-structured interview guide to collect information needed to fill that gap, and recruited respondents from the R/R DLBCL community including patients, physicians, and caregivers. Using template analysis to code the interview transcripts, we helped to fill RWE gaps on patient and provider priorities, preferences, and perceptions, and on the role of caregivers, in selecting second- and third-line R/R DLBCL treatments.
 

Elements of effective decision making

Success

Study results highlighted major gaps that limit patient and caregiver engagement in selecting second- and third-line treatments for R/R DLBCL. For example, caregivers play a major role in helping to select treatments for patients, yet few tailored materials exist to guide caregivers in this role. Interviews also revealed shortcomings in patient-physician interactions during treatment selection.

Physicians lack the resources they need to coordinate with each other when treating a patient, leading to duplicative efforts in patient-provider interactions. Additonally, patient shock at diagnosis and treatment failure—combined with pressure felt to select a subsequent treatment quickly—reduces the quality of patient and provider interactions, and, in turn, shared decision-making. Each of these gaps presented an opportunity to create tools and processes that could improve patient experiences, treatment selections, and health outcomes for those living with R/R DLBCL.

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