Despite the availability of effective antivirals, patients with COVID-19 at high risk of progression to severe COVID-19 remain undertreated, leading to avoidable patient- and system-level burden. We conducted a qualitative concept elicitation study to identify key drivers and barriers to prescribing antivirals, informing a future quantitative preference survey on factors impacting COVID-19 antiviral utilization.Table 1.COVID-19 Antiviral prescribing drivers and barriers by relevant Theoretical Domains Framework domain Sixteen US physicians [6 primary care (PC), 5 urgent care (UC), and 5 emergency medicine (ER)] participated in individual 45-minute semi-structured virtual interviews with a moderator, guided by the Theoretical Domains Framework (TDF), a 14-domain framework for identifying determinants of behavioral change, between November 2024-January 2025. The interviews were transcribed and thematically analyzed using MAXQDA® qualitative analysis software. Concept saturation was attained by the 16th interview. Key drivers of antiviral prescribing included reducing hospitalization and/or death, along with symptom reduction for high-risk patients (older adults and those with comorbidities, such as cardiovascular disease, pulmonary conditions, immunosuppression, obesity, and diabetes) were key concepts identified. Oral antivirals were preferred over IV in an outpatient setting. Barriers included uncertainty about the benefits of antivirals in vaccinated patients or high-risk individuals with mild symptoms. Reluctance to modify medication regimens because of potential drug-drug interactions (DDIs) was also cited as a deterrent, particularly among ER and UC physicians, who face time constraints and complex treatment considerations. All physicians reported that patient preferences play a substantial role in antiviral prescribing decisions. Drivers, barriers, and the number of respondents who mentioned them within each TDF domain are summarized in Table 1. Physicians view antivirals as an effective tool for treating patients with COVID-19 at high risk for progression to severe COVID-19, yet this study identified factors that may deter prescribing. Further research is needed to quantify the influence of specific drivers and barriers to prescribing antivirals for COVID-19. Maria Fernandez, PhD, MBA, Pfizer Inc.: Employee and may hold stocks Domenick Francis, PharmD, Pfizer: Stocks/Bonds (Public Company) Iqra Naz Arham, PharmD, RPH, Pfizer: Stocks/Bonds (Public Company) Joshua R. Coulter, MA, Pfizer: Stocks/Bonds (Private Company) Brett Hauber, PhD, Pfizer Inc: Stocks/Bonds (Private Company) Shoaib Khan, MD, Pfizer: Stocks/Bonds (Public Company) Lewis Kopenhafer, BA, Oracle America, Inc: Employee William You, MSPH, Pfizer Inc.: Advisor/Consultant Kathleen Beusterien, MPH, Oracle America, Inc.: Employee Martine C. Maculaitis, PhD, MA, Oracle Life Sciences: Employee of Oracle Life Sciences, which received funding from Pfizer to conduct the study. Soohyun Hwang, PhD, MPH, Pfizer: Employed by Oracle Life Sciences, which received funding from Pfizer to conduct the study. Mary M. Moran, MD, Pfizer Inc.: Employee of Pfizer Inc. and may hold stock or stock options Ruth Mokgokong, PhD, Pfizer: Employee|Pfizer: Stocks/Bonds (Private Company)

Migraine imposes significant burdens on individuals and healthcare systems. While clinical trials have demonstrated the efficacy and safety of acute treatments, real-world patient experiences offer critical insight into treatment acceptability and impact on quality of life. This study explores patient experience with zavegepant 10 mg intranasal (IN) as an acute treatment for migraine attacks. Adults with a self-reported migraine diagnosis who had used zavegepant for acute treatment of migraine attacks in the past 3 months participated in semi-structured in-depth interviews. Participants were recruited via a research panel. Interviews explored treatment usage patterns and outcomes. Participants also completed a point allocation exercise, assigning 100 points across seven zavegepant features based on relative importance. Transcripts were analyzed in MAXQDA using content analysis. Fifteen patients participated (mean age = 42; range 23–63 years). Zavegepant was generally perceived as effective, fast-acting, and convenient, contributing to high overall satisfaction. Patients with multiple migraine medications on hand usually choose zavegepant for severe attacks or when they need to continue performing their planned activities. Many reported receiving insufficient guidance from healthcare providers on correct administration timing and technique. Dysgeusia (a bitter, metallic taste) was commonly reported. Most expressed willingness to continue using zavegepant despite dysgeusia, citing significant physical, emotional, and daily functioning improvements. In the point allocation exercise, "freedom from pain" was rated as the most important attribute, three times more important than “nasal spray as mode of administration” and “taste of the medicine.” Overall, zavegepant 10 mg IN was perceived as an effective and fast-acting acute treatment for migraine attacks. Although side effects such as dysgeusia may delay or reduce use in some patients, most value zavegepant’s effectiveness and functional benefits. These findings underscore the need for improved patient education on administration techniques and side effects to optimize real-world outcomes.

BACKGROUND:Low-density lipoprotein cholesterol (LDL-C), among other lipids, is a strong causal and modifiable risk factor for atherosclerotic cardiovascular disease (ASCVD). However, lipid-lowering therapy (LLT) is underutilized and many patients do not reach LDL-C goals. OBJECTIVES:This study aimed to evaluate patient preferences for LLT attributes to inform shared decision-making and improve treatment adoption and adherence. METHODS:Adults ≥40 years with elevated LDL-C and a recommendation for LLT completed a cross-sectional, web-based survey assessing treatment experiences and preferences. A discrete choice experiment elicited preferences across 7 attributes: LDL-C reduction, stroke risk, heart attack risk, revascularization risk, new-onset diabetes, musculoskeletal pain, and regimen/mode of administration. Survey responses were analyzed using univariate and bivariate methods. Preference weights (PW) and relative importance were estimated using hierarchical Bayesian modeling. RESULTS:Among 508 participants (mean age: 62.8 ± 11.4 years), 49.0% had prior ASCVD, 55.3% were female, and 43.9% were current or former smokers. Participants prioritized immediate and tangible treatment features over long-term benefits. Mode of administration was the most influential attribute (relative importance = 25.9). A once-daily oral pill was most preferred (PW = 1.75), followed by a daily pill plus a second oral pill before breakfast (PW = 0.17), whereas regimens including biweekly injections were least preferred (PW = -1.13). Higher perceived ASCVD risk was associated with greater emphasis on cardiovascular risk reduction and less emphasis on regimen. CONCLUSIONS:Mode of administration is a key driver of LLT preferences. Incorporating patient preferences into shared decision-making may improve adherence and implementation of guideline-directed therapy.

IntroductionWith advances in targeted early breast cancer (eBC) treatment, research is needed to understand the factors influencing biomarker testing and respective treatment selection among physicians in routine clinical practice. The purpose of this study was to evaluate factors influencing oncologist decisions for germline BReast Cancer gene (BRCA) mutation (gBRCAm) testing and adjuvant therapy in human epidermal growth factor receptor 2-negative (HER2-) early breast cancer (eBC).Materials and methodsUS oncologists completed an online survey from April to July 2024, which included preference exercises to evaluate the relative importance of select factors for gBRCA testing and adjuvant treatment selection in gBRCAm HER2- eBC.ResultsAmong 150 surveyed oncologists, age was over twice as influential as tumor size and lymph node involvement in gBRCA testing decisions for hormone receptor-positive (HR+)/HER2- eBC. Nearly one-quarter reported that gBRCA test results did not impact their treatment decisions. Olaparib-based regimens were the preferred adjuvant treatment for gBRCAm HER2- eBC, over Cyclin-Dependent Kinases 4 and 6 inhibitors alone for HR+/HER2- eBC, immunotherapy or capecitabine alone for triple-negative eBC, and no treatment. Efficacy was the most important treatment attribute. Oncologists reported that patient unwillingness to undergo gBRCA testing or receive adjuvant olaparib due to cost, treatment duration, or other reasons were barriers to treatment.ConclusionsDespite guideline recommendations, age drives oncologists’ gBRCA testing decisions. To support the preference for olaparib-based adjuvant treatment in gBRCAm HER2- eBC, increased physician awareness of guidelines and the rationale for gBRCAm testing is needed to improve identification of eligible patients.

Objective(s) Lyme disease is the most common vector-borne illness in the United States, with an estimated 476,000 cases diagnosed and treated annually. Although incidence is highest among White individuals, people of color are more likely to experience severe or disseminated manifestations. This study explored factors contributing to this disparity by examining experiences of people of color diagnosed with Lyme disease. Setting Participants resided in high-incidence U.S. states. Participants Self-identified people of color diagnosed with Lyme disease within the past 12 months. Methods Fifteen participants completed in-depth interviews analyzed using inductive and deductive qualitative content analysis. Follow-up focus groups supported consensus-building and thematic refinement. Results Key themes included limited awareness that people of color are at risk for Lyme disease, perceived discrimination in health care encounters, diagnostic delays attributed to the characteristic erythema migrans (EM) rash being less visible on darker skin, and insufficient physician knowledge regarding diverse clinical presentations. Participants also expressed a preference for racially concordant providers. Lyme disease affected physical health, emotional well-being, social relationships, and engagement in outdoor activities. Conclusions People of color may face distinct challenges in Lyme disease recognition and management, contributing to disparities in outcomes. Findings underscore the need for targeted education for at-risk populations, patients and providers and for equitable prevention and diagnostic strategies.

Advanced therapies (ATs) for ankylosing spondylitis (AS) vary in processes related to treatment administration. We hypothesized that treatment preferences for patients with AS vary based on AT experience and disease status. This cross-sectional, mixed-methods study collected data from adults (aged ≥ 18 years) in the United States, United Kingdom, and Italy who had a confirmed AS diagnosis and a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score ≥ 4 and/or were currently taking AT. Burdensome aspects of AS and important AT administration attributes were identified in qualitative interviews with ten eligible patients. A cross-sectional online survey was also conducted, including a best–worst scaling (BWS) exercise with 12 treatment administration-related attributes and a series of six fixed-choice tasks, which presented two options varying only in mode and frequency of administration. Attribute relative importance was calculated from BWS data to sum to 100 across attributes. Frequencies and percentages were reported for fixed-choice tasks. Preferences from BWS data were compared by treatment/disease status (on AT/well controlled, on AT/not well controlled, not on AT/not well controlled) using one-way analysis of variance tests. In qualitative interviews, patients reported pain (70.0

Poly(ADP-ribose) polymerase inhibitors (PARPi) have survival benefits for patients with high-risk (High-risk disease is defined per the phase III OlympiA trial as follows: for triple-negative breast cancer, residual disease after neoadjuvant chemotherapy or node-positive or ≥ 2 cm tumors after adjuvant chemotherapy; for hormone receptor-positive disease, four or more positive nodes after adjuvant chemotherapy or a CPS + EG score ≥ 3 after incomplete response to neoadjuvant chemotherapy. The CPS + EG score accounts for clinical/pathologic stage, ER status, and grade (Giaquinto et al. in CA Cancer J Clin 72:524–541, 2022)), human epidermal growth factor receptor 2 (HER2)-negative early breast cancer (eBC) with germline BReast CAncer gene mutations (gBRCAm). However, many patients are unaware of their gBRCA status; this can impact eligibility for targeted treatment. We sought to evaluate patient preferences for BRCA testing and treatment decision-making as they relate to HER2-negative eBC. We conducted an online survey, including a best–worst scaling exercise (BWS) and discrete-choice experiment (DCE), among patients with self-reported HER2-negative eBC residing in the USA who were either untested, unsure if they were tested, or tested positive for the gBRCAm. The BWS generated a rank ordering of 16 barriers and facilitators to BRCA testing. The DCE evaluated patient preferences for adjuvant therapies versus no treatment based on seven treatment attributes: invasive disease-free survival, targeted treatment, nausea risk, risk of serious side effects, regimen, treatment duration, and cost. BWS and DCE exercises were analyzed using hierarchical Bayesian models. Among the 359 women included in our sample, the top facilitators for BRCA testing were determining eligibility for targeted therapy that may prevent or delay metastasis, a physician’s recommendation, and absence of out-of-pocket costs (OOPC). In contrast, the top barriers were an OOPC of 250, potential anxiety from test results, and the possibility of a 3- to 4-week delay in treatment. The DCE showed that most participants preferred adjuvant treatment (77.6

Digital health technologies (DHTs) can quantify changes in physical activity in cachexia clinical studies. But what is a meaningful change? We estimated the meaningfulness to patients with cachexia and cancer of incremental changes in ability to perform physical activities of different intensity and time spent each day doing non-sedentary activity that can be measured with DHTs. An online survey was conducted with US adults with cachexia and cancer. Meaningfulness of 14 changes in ability to perform physical activities and 3 increases in daily time spent in non-sedentary activity were assessed on a 5-point rating scale (not at all meaningful to extremely meaningful). Subgroups (tumor type, cancer stage, ECOG performance status) were compared using chi-square (or Fisher’s exact) tests. Overall, 181 patients participated. All changes in physical activity intensity, and both a 14-min and a 30-min increase in time spent in non-sedentary activity/day, were at least moderately meaningful to most patients, regardless of tumor type, cancer stage, or ECOG performance status (Table). Some meaningfulness ratings differed significantly by tumor type (both walking pace and distance were less meaningful in NSCLC and sitting to standing was less meaningful in pancreatic) and performance status (walking pace was less meaningful in patients with ECOG 3-4). Majorities of patients, except for those with colorectal, rated a 4-min increase/day in non-sedentary activity as at least moderately meaningful. Patients with cancer and cachexia perceived even small changes in physical activities and time spent in non-sedentary activity as being at least moderately meaningful, suggesting that DHTs that measure changes in movement duration can be used to capture important patient-centric endpoints in clinical studies. Table Change in Ability to do Physicial Activities Proportion of Patients Rating Each Change as at Least Moderately Meaningful All Patients Tumor Type Cancer Stage Performance Status NSCLC Breast Colorectal Pancreatic Other Stage I-III Stage IV Higher Lower N=181 N=20 N=69 N=30 N=15 N=47 N=123 N=52 N=147 N=34 Cannot go walking outside to Able to walk a short distance 93.9% 95.0% 94.2% 93.3% 93.3% 93.6% 92.7% 98.1% 93.9% 94.1% Able to walk a short distance to Able to walk a long distance 90.6% 65.0%* 91.3%* 96.7%* 100.0%* 93.6%* 91.9% 88.5% 91.8% 85.3% Cannot walk, even at a slow pace to Able to walk at a slow pace 94.5% 100.0% 95.7% 93.3% 93.3% 91.5% 93.5% 98.1% 95.9% 88.2% Able to walk at a slow pace to Able to walk at an average walking pace 90.6% 70.0%* 92.8%* 93.3%* 100.0%* 91.5%* 89.4% 94.2% 93.2%* 79.4%* Able to walk at an average walking pace to Able to walk at a fast pace 79.6% 70.0% 78.3% 93.3% 93.3% 72.3% 79.7% 78.8% 80.3% 76.5% Cannot be up and about to Able to be up and about for <1 hour a day 93.9% 100.0% 92.8% 93.3% 100.0% 91.5% 94.3% 94.2% 94.6% 91.2% Able to be up and about for <1 hour a day to Able to be up and about 3 hours a day 96.1% 100.0% 94.2% 90.0% 100.0% 100.0% 95.1% 100.0% 95.9% 97.1% Able to be up and about 3 hours a day to Able to be up and about 6 hours a day 92.3% 80.0% 89.9% 93.3% 100.0% 97.9% 90.2% 98.1% 92.5% 91.2% Cannot move from sitting to standing to Able to move from sitting to standing with effort 89.0% 95.0%* 91.3%* 100.0%* 60.0%* 85.1%* 88.6% 92.3% 89.8% 85.3% Able to move from sitting to standing with effort to Move from sitting to standing easily 95.0% 100.0% 94.2% 100.0% 100.0% 89.4% 95.1% 96.2% 95.9% 91.2% Cannot do any activities, even while sitting to Able to do activities while sitting 95.0% 95.0% 92.8% 100.0% 100.0% 93.6% 94.3% 98.1% 95.2% 94.1% Able to do activities while sitting to Able to do light activities 96.1% 100.0% 94.2% 93.3% 100.0% 97.9% 97.6% 94.2% 97.3% 91.2% Able to do light activities to Able to do moderate activities 91.2% 95.0% 87.0% 93.3% 93.3% 93.6% 91.1% 92.3% 92.5% 85.3% Able to do moderate activities to Able to do vigorous activities 75.7% 60.0% 75.4% 80.0% 86.7% 76.6% 78.9% 67.3% 78.2% 64.7% Able to do non-sedentary activities for an additional 4 minutes per day 65.2% 65.0%* 75.0%* 48.1%* 86.7%* 60.9%* 70.0% 62.7% 66.4% 69.7% Able to do non-sedentary activities for an additional 14 minutes per day 76.2% 80.0% 77.9% 66.7% 93.3% 80.4% 79.2% 76.5% 79.0% 75.8% Able to do non-sedentary activities for an additional 30 minutes per day 85.6% 90.0% 89.7% 85.2% 100.0% 82.6% 88.3% 88.2% 88.8% 84.8% * indicates statistically significant differences (P<0.05) in proportion among subgroups Carrie Northcott, Abigail Newell, Soohyun Hwang, Josh Coulter, Lewis Kopenhafer, Mar Santamaria, Isik Karahanoglu, Martine C. Maculaitis, Joseph C. Cappelleri, Kathleen Beusterien, Maria Gonzalo, Erica Fortune, Claire Saxton, Elif Andac-Jones, Brett Hauber. Meaningful change in the ability to perform physical activities for patients with cachexia and cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 2517.

Background Novel immunotherapies such as bispecific antibodies (BsAbs) are rapidly changing the treatment landscape for RRMM, with improved outcomes for patients. As these treatments vary in efficacy, toxicity, dosing, and mode of administration, it is important to better understand how patients view such differences, and which factors they prioritize when selecting treatment. Objective This study aimed to identify factors that influence treatment decisions among patients with RRMM in the US and five European countries and how they prioritize attributes or outcomes associated with BsAbs. Methods From January to May 2025, one-on-one virtual interviews were conducted with patients who self-reported a diagnosis of MM and had completed 1 or more lines of treatment (LOT) in the United States, United Kingdom, France, Germany, Italy, and Spain. Open-ended questions were asked about factors that influence treatment decisions. Next, patients were asked to rate the meaningfulness of differences between the highest and lowest level of each treatment attribute related to administration, efficacy, and adverse events on a scale of 1 to 7 (1 = least meaningful, 7 = most meaningful). The attributes and levels were informed by clinical data available for elranatamab, linvoseltamab, talquetamab, and teclistamab. Finally, patients were asked to select the single most and single least meaningful attribute per category based on the difference in highest and lowest levels, reflecting their overall prioritization. A thematic analysis of responses to the open-ended questions was performed. Attribute wording was revised throughout the interview process in response to feedback. Summary statistics for patient characteristics, attribute ratings, and ranking outcomes were calculated. Results Thirty patients (5 per country) with a mean age of 56 years (range, 29-77) participated; 57% were female, and 57% had 3 or more LOTs. When asked about factors influencing treatment decision-making, most patients mentioned efficacy in some form. Key themes that emerged included achieving a “response” and “remission”, “that it works”, relieving symptoms and being able to perform daily activities, keeping the “disease under control”, “stop relapses”, and becoming treatment-free for as long as possible. Patients were willing to prioritize efficacy over toxicity risk, and a longer expected duration of response made side effects a lesser concern. Among the efficacy attributes, increased overall survival had the highest mean meaningfulness rating of 6.6. When asked to identify the single most meaningful efficacy attribute based on the difference between highest and lowest levels, the three efficacy attributes most often identified were related to response (n=24): chance of complete response, duration of response, or chance of any type of response. Among the side effects attributes, increased risk of grade 3-4 infections was most often identified as most meaningful (n=8), followed by the increased risks of immune effector cell-associated neurotoxicity syndrome (ICANS) (n=5) and of dysgeusia (n=4). When rating each side effect attribute independently based on the differences, the increased risk of skin-related side effects received a mean rating that was the same as the increased risk of grade 3-4 infections (6.2). Among the administration attributes, dosing schedule (n=10), mode of administration (n=8), and hospital stay at the beginning of treatment (n=6) were most often ranked as most meaningful. ConclusionsThis multi-country mixed methods study provides valuable information on what matters to patients when choosing among BsAbs for RRMM. Healthcare professionals should incorporate these insights into shared decision-making to better align treatment plans with patient values and priorities. The findings highlight the need for a large-scale quantitative study to more systematically assess patient preferences and quantify the trade-offs that patients are willing to make among key attributes in treatment selection. The results of this study will directly inform the design and selection of attributes for a discrete choice experiment (DCE). Based on the findings, a patient DCE focusing on BsAbs for treatment of RRMM should include attributes related to mode of administration, dosing schedule, survival, response rate, serious side effects like ICANS and grade 3-4 infections, and quality of life-related side effects, such as loss of taste and skin-related side effects.

Background:Few studies have explored physician and patient preferences for the treatment of chronic lymphocytic leukemia (CLL) related to treatment efficacy, adverse events (AEs), and treatment duration. Thus, this observational, mixed-methods study investigated patients' and physicians' preferences for CLL first-line treatments. Materials and Methods:An online discrete choice experiment in five countries among 192 patients and 259 physicians in the US, the UK, Germany, France, and Australia examined the importance of outcomes and treatment attributes. Results:Increasing 5-year progression-free survival (5-year PFS) was most important to patients and physicians, with a relative importance (RI) of 30.3% among patients and 37.8% among physicians, followed by reducing the risks of common side effects (RI 21.6% among patients, 22.9% among physicians) and adverse events (AEs) leading to treatment discontinuation (RI 22.1% among patients, 20.6% among physicians). Patients strongly preferred time limited treatment regimen over treatment to progression (TTP). Specifically, patients and physicians would require a 6.4% vs 2.3% increase in 5-year PFS, a 19.4% vs 8.9% decrease in the risk of common all grades side effects, and a 7.5% vs 3.7% decrease in the risk of treatment discontinuation due to AEs, respectively, to compensate for a daily oral medication taken indefinitely vs daily oral medication taken for 24 months. Conclusion:Overall, patients and physicians favor time-limited treatment regimens over TTP and value treatments with greater PFS benefits followed by lower side effects. Patients and physicians were both willing to trade-off switching from time-limited treatment to TTP for a better 5-year PFS, decrease side effects, and risk of treatment discontinuation due to AEs.

Anti-obesity medications (AOMs) improve weight loss and weight-related outcomes, compared with behavioral approaches alone. Despite this, few patients are prescribed AOMs. The aim of the present study was to explore potential psychological factors related to willingness to take AOMs. Adult persons with obesity (PwO) completed an online survey focused on attitudes, perceptions, and motivations around obesity care. Seven predictor factors were identified via exploratory and confirmatory factor analysis. A multivariable analysis showed the following to influence willingness to take AOMs: having a doctor involved in their weight loss journey, having experienced social or emotional problems with weight, being motivated to lose weight for social or health reasons, and experiencing weight-related stigma; perceiving that lifestyle intervention is sufficient for maintaining weight loss is a deterrent. Mediation analyses showed that having social or emotional problems because of excess weight and social/health motivations for weight loss were both significant predictors of willingness to take AOMs, with desire for health care provider (HCP) involvement and weight-related stigma positively, and belief in the sufficiency of lifestyle changes negatively, mediating these effects. These findings highlight the complexity of psychological and behavioral factors related to obesity care and how PwO perceive that AOMs may be able to help them.

Background: PARP inhibitors (PARPis) have survival benefits for women with high-risk HER2-negative early breast cancer (eBC) with germline BRCA mutations (BRCAm). Identifying patients eligible to receive PARPis can be challenging, as many individuals who are BRCAm carriers are unaware of their status, despite increasing availability of genetic testing. This study sought to identify factors that influence patient preferences for BRCA testing and adjuvant therapy. Methods: Women (≥18 years) in the United States with HER2-negative eBC were recruited between October 2023 - March 2024 via an online research panel to complete a cross-sectional survey. The survey included a Best-Worst-Scaling (BWS) exercise to identify barriers/facilitators to BRCAm testing among 16 factors. Two Discrete Choice Experiments (DCE) were included: one to evaluate preferences for BRCA testing by prompting patients to select between 2 hypothetical scenarios varying on 5 testing-related attributes (i.e., eligibility for targeted treatment, delays due to testing, information sharing with family, preventive surgery options, and out-of-pocket costs [OOPC]) and another to assess the influence of 7 treatment attributes on patients’ preferences for adjuvant therapy (i.e., invasive disease-free survival, whether the treatment is targeted, risk of nausea, risk of serious side effect [SSE], regimen, treatment duration, and monthly treatment OOPC) versus no treatment. Attributes included in the BWS and DCE exercises were informed by qualitative interviews with 20 healthcare providers and 12 patients. BWS and DCE attribute preference weights were calculated using hierarchical Bayesian modeling. Results: Women (N=360) on average were 61 years old and 77% were White; most resided in the South (37%) and Midwest (23%). Most women were first diagnosed with breast cancer after 2017 (72%), 61% were never tested for BRCAm or unsure of their status/testing history. Roughly one-third received adjuvant chemotherapy and another third received neoadjuvant chemotherapy. Relative to the other factors in the BWS, the top facilitators for BRCA testing were the possibility of test results showing eligibility for targeted therapy that may prevent or delay metastasis, having no OOPC for testing, and physician recommendation. OOPC of $250, potentially delaying treatment by 3-4 weeks and concerns that test results could lead to denial of life insurance/higher premiums were the top three barriers. The DCE evaluating preferences for BRCA testing showed that, on average, decreasing OOPC from $250 to no cost was most important, followed by learning if preventive surgery should be considered to prevent new cancer, and learning about eligibility for targeted treatment. The DCE on preferences for adjuvant therapy showed that 77% of the time, patients chose treatment over opting out, regardless of the combination of adjuvant treatment attributes shown. On average, reducing treatment OOPC from $900 to $0 influenced treatment choice most, followed by reducing risk of SSE from 77% to 24%, and having a BRCA-targeted treatment. Conclusions: Patients reported that a key benefit of BRCA testing was using the results to inform treatment decisions. Yet, OOPC may act as a barrier to testing. Patients’ decision to receive adjuvant therapy was influenced by the perceived effectiveness and tolerability of the therapy, and like BRCA testing, financial burden was a concern. Comprehensive patient-provider discussions regarding the benefits of testing including eligibility for innovative treatment may be an effective strategy for increasing BRCA testing and enhancing shared treatment decision-making. Selection of effective adjuvant treatment likely requires balanced consideration of medication tolerability and financial burden to the patient. Citation Format: Kathryn Mishkin, Kathleen Beusterien, Josh Lankin, Emily Mulvihill, Kathryn Krupsky, Alexandra Gordon, Xiaoqing Xu, Qixin Li, Jaime Mejia, Kim Hirshfield, Jagadeswara Rao Earla. Key factors influencing patient preferences for BRCA testing and adjuvant therapy in HER2-negative early breast cancer [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P2-12-06.

OBJECTIVE:The objective of this study was to understand the perceptions of and drivers/barriers to antiobesity medication (AOM) use among people with obesity (PwO) and health care providers (HCPs) in the United States. METHODS:In 2022, PwO and HCPs completed cross-sectional surveys that included questions on perceptions of obesity management and AOMs. Data were analyzed using descriptive statistics. RESULTS:Survey participants (1007 PwO and 474 HCPs) emphasized the effectiveness of lifestyle change and the patient's responsibility to address obesity. PwO reported a willingness to take newly approved AOMs long term. HCPs believed that their patients would adhere to AOMs long term if they experienced success. Both PwO and HCPs perceived an increased effectiveness of a multimodal approach to combining AOMs with HCP-guided lifestyle intervention. Potential barriers to long-term use of AOMs for both groups included concerns regarding long-term side effects and outcomes, costs and insurance coverage, and perception of AOMs that do not align with treatment of a chronic disease. CONCLUSIONS:PwO and HCPs are interested in new AOM options, but educational gaps remain as a barrier to recommended multimodal chronic care. Ongoing education that includes the known effectiveness and safety data of newer AOMs and pending outcome trials could improve shared decision-making in obesity care.