Better Shared Decision Making for Patients with R/R DLBCL

Patients with 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, lack of 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 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.

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 among each other when treating a patient, leading to duplicative efforts in patient-provider interactions, and 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 thus of shared decision making. Each of these gaps represents an opportunity to create tools and processes that could improve patient experiences, treatment selections, and health outcomes for those living with R/R DLBCL.