Clinicians’ Perspectives on the Impact of Different Attributes of Androgen Receptor Pathway Inhibitors on Prostate Cancer Treatment Preferences and Compliance in Mexico

INTRODUCTION: Androgen receptor pathway inhibitors (ARPIs) are a critical prostate cancer (PC) treatment option. Previous research has suggested that the physical attributes of ARPI medications (e.g., pill formulation, pill shape, pill size, dosing) may influence patients' treatment satisfaction, adherence, and persistence, which may impact patient outcomes and quality of life. The objective of this study was to describe Mexican clinical experts' perspectives on how different attributes of pill forms of ARPIs may affect treatment preferences and compliance in patients with PC. METHODS: This study employed a mixed-methods sequential design. In the first phase, we conducted a targeted literature review (TLR) to frame discussions with clinical experts. In phase 2, we conducted a structured expert elicitation (SEE) comprised of a survey, semi-structured individual interviews, and two focus groups with oncologists and urologists to gather insights about the influence of different ARPI attributes on patient preferences and compliance. In the third phase, we constructed a series of probabilistic mathematical models to analyze the likelihood of patients' treatment preferences and adherence. RESULTS: The TLR identified pill size, shape, number, frequency, and form as key attributes that influence patients' experiences and treatment compliance. Simpler regimens and smaller, easier-to-swallow formulations were consistently linked to greater comfort and adherence. In the SEE, participants ranked dosing frequency and pill count as the factors with the greatest influence on patient adherence when efficacy was comparable. During the interviews and focus groups, participants highlighted the importance of ≤ 2 pills/day, once-daily dosing, and small pill size alternatives. Findings from the Monte Carlo models were consistent with the earlier phases, supporting the importance of patient-preferred formulations. CONCLUSIONS: Findings from this mixed-methods study indicate that patient-preferred formulations may support better treatment adherence and support consideration of patient preferences in treatment decision-making between clinicians and patients to optimize adherence and outcomes in PC management.