Objective A patient decision aid (PtDA) is often developed and evaluated to support shared decision making (SDM) and a patient‐centred approach. In this study, a PtDA template was developed to support two different preference sensitive decisions: adjuvant therapy for breast cancer and diagnostic workup for lung cancer. The aim of the study was to explore whether a PtDA improved SDM and supported a patient‐centred approach from an observational point of view. Methods Real‐life observations were conducted using the validated observational instrument OPTION 12. Three nurses conducted observations of consultations in two different clinical settings. The study consisted of a baseline cohort (phase 1) and an intervention cohort (phase 2). In phase 1, standard consultations were observed. Subsequently, the PtDA was introduced, and in phase 2, consultations with the clinician using the PtDA were observed. Results Twenty‐nine observations were conducted in phase 1 and 24 in phase 2. Using a PtDA increased the overall OPTION score significantly (P < .0001), both in decisions on adjuvant treatment for breast cancer and on diagnostic workup of lung cancer. Items in the OPTION instrument regarding systematic conversation to obtain SDM had a higher increase of scores compared to items regarding a patient‐centred approach. Conclusion Real‐life observations and the use of a validated observational tool provided comprehensive knowledge as to how a PtDA affects SDM in consultations. Applying a PtDA resulted in a significant overall increase of SDM behaviour in decisions on adjuvant treatment after breast cancer surgery and diagnostic workup in case of a small suspicion of lung cancer. In conclusion, the PtDA supports SDM in consultations independently of type of decision and department.

Purpose:The increasing population of breast cancer survivors highlights the need to (re)consider how we utilize available services for survivorship care in oncology clinics.Electronic Patient Reported Outcomes (ePROs) can be used to identify patients' individual care needs and triage them to the right services. We examined the impact on service use, workflow and workload following the introduction of an ePRO based individual follow-up (PIFU) for women treated for early breast cancer.Methods: A multi-method approach was used. In a pilot randomized controlled trial the use of consultations, telephone calls and specialist referrals were systematically recorded. Comparison was done between PIFU and standard follow-up care (SFU).Focus group interviews with nurse navigators evaluated the impact on workflow and workload qualitatively. Results:The 64 women randomized to attend SFU used a mean of 3.8 (95% CI: 3.5 -4.1) planned consultations during the two-year study period compared to a mean of 1.9 consultations (95% CI: 1.4 -2.4) for the 60 women randomized to PIFU (P < 0.001).Urgent appointments were more frequent in SFU (mean of 0.47 vs 0.22 per patient, P = 0.03). No statistically significant differences were observed in the use of telephone calls and specialist referrals. The nurse navigators did not experience an increase in their workload, but implementation of PIFU may require a re-structured workflow. Conclusions: The ePRO based individual follow-up could change organization of care and re-allocate services for those in need of it. Implications for Cancer Survivors: ePRO based individual follow-up could potentially ensure more time for those most in need of face-to-face care.

OBJECTIVE: To systematically review evidence on the characteristics, experiences and impact of an open dialogue about complementary and alternative medicine (CAM) integrated in oncology care. METHODS: We searched MEDLINE, EMBASE, AMED, Scopus, ProQuest Dissertations and Thesis, Cochrane Central Register, clinicaltrials.gov, forskningsdatabase.dk and PROSPERO. Two reviewers screened title, abstract and full-text articles. Each study was appraised using the Critical Appraisal Skills Programme (CASP) and synthesized narratively. PROSPERO registration CRD42019112242. RESULTS: We retrieved 4736 articles and included 5; 3 received 9 ½, 1 received 9, and 1 received 5 points on the CASP score. Predominately, the open dialogue was one or two individual, patient-centered, face-to-face consultations led by oncology physicians. In one study, it was a tele-phone consultation and in another it was structured counseling led by pharmacists. Integrated information and recommendations about CAM contributed to high level of satisfaction and improvement in concerns, quality of life and well-being. CONCLUSION: Integration of open dialogue about CAM in oncology care including acknowledging patients' preferences, values, wishes and knowledge, and providing information about CAM expands the opportunities for improving patients' health, quality of life and wellbeing. PRACTICE IMPLICATIONS: Open dialogue about CAM has potentials, but research on how it specifically helps patients, is needed.