Shah SN, Hepp Z, Martin S, Harris N, Morgans A. Qualitative analysis of PAIN in patients with locally advanced or metastatic urothelial cancer. Poster to be given at the Virtual ISPOR Europe 2020; November 2020. [abstract] Value Health. 2020 Dec; 23(S2).


Objective: To characterize pain and its impact in patients with locally advanced or metastatic urothelial cancer (la/mUC) treated in the first-line setting and to assess the content validity of the Brief Pain Inventory Short Form (BPI-SF) worst pain item in this population.

Methods:
One-hour semi-structured qualitative interviews were conducted in US patients meeting these criteria: aged ≥45 years, physician-confirmed la/mUC receiving first-line treatment, self-reported la/mUC-attributed pain >0 (0 [none] to 10 [as bad as you can imagine] scale) prior to enrollment, and no major surgeries ≤3 months prior to the interview. Patients were asked open-ended questions about their la/mUC symptoms and la/mUC pain (eg, location, impacts on their life); areas of interest not spontaneously mentioned were probed. “Think aloud” cognitive debriefing was conducted for the BPI-SF worst pain item.

Results: Sixteen patients (laUC, n=10; mUC, n=6) were interviewed (mean age, 53.8 years; male, n=8). All patients were diagnosed within ≤5 (mean, 2.73) months of study entry. First-line treatments included cisplatin-containing (n=14) or carboplatin-gemcitabine (n=2) therapies. The average past-week worst pain score was 6.2 (range, 3-10). Pain was the most commonly reported symptom (n=16) related to la/mUC. Pain was frequently reported in the back (n=14) and pelvic/lower abdominal area (n=10). All patients reported that pain impacted their physical and daily activities and most (n=13) reported it impacted overall quality of life. All patients correctly interpreted and easily completed the BPI-SF worst pain item; 15 reported that it was relevant to their la/mUC experience. Patients understood the 24-hour recall period; most supported daily (n=13) or weekly (n=14) assessment and preferred electronic administration using their device (n=14).

Conclusions: In patients with la/mUC-attributed pain receiving first-line treatment, these results indicate that pain impacts patients’ lives, including physical and daily activities, and demonstrates BPI-SF worst pain item content validity in this population.

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