Patient Priorities in Treatment Decision‐Making for RRP : A Discrete Choice Experiment

OBJECTIVE: Recurrent respiratory papillomatosis (RRP) profoundly affects quality of life due to frequent surgeries. Although emerging non-surgical options such as bevacizumab and HPV-specific immunotherapies show promise, little is known about patient interest or treatment decision-making. This study explored RRP patients' treatment preferences using a stated-preference framework to guide patient-centered therapy development. METHODS: A two-part approach was used. First, semi-structured interviews (n = 10) with randomly selected RRP patients identified key treatment priorities. The three most frequently cited attributes were incorporated into a discrete-choice experiment (DCE) distributed to RRP patients with standardized educational materials on bevacizumab and HPV-specific immunotherapies. Participants completed choice tasks and indicated their preferred treatment. Preferences and attribute importance were estimated using hierarchical Bayes modeling. RESULTS: Interview participants most often prioritized likelihood of needing future surgery, frequency of non-surgical treatment, and side effects. Sixty-six quality-controlled DCE responses were analyzed. All attributes significantly influenced treatment choice (p < 0.001) and followed logical, monotonic utility patterns. Side effects were most influential (55.1%), followed by likelihood of future surgery (36.5%) and treatment frequency (8.4%). Overall, patients preferred HPV-specific immunotherapy (48%) or bevacizumab (44%) over awake or asleep surgery (8%). CONCLUSION: This is the first quantitative study of RRP patient treatment priorities. We found that patients overwhelmingly value therapies that reduce surgical burden and side effects, highlighting a critical unmet need in current management. These findings capture the patient perspective and establish a foundation for aligning future research and clinical efforts with what matters most to those living with RRP. LEVEL OF EVIDENCE: N/A.