Adjuvant chemotherapy in elderly women with breast cancer: patients' perspectives on information giving and decision making

Harder, Helena; Ballinger, Rachel; Langridge, C.; Ring, Alistair; Fallowfield, Lesley

doi:10.1002/pon.3338

Cited by 43 publications

(68 citation statements)

References 36 publications

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“…In the oBCP, side effects have led to a number of publications on treatment efficacy [19,21,24,40], consenting [23], quality of life [18,25], increasing the rate of therapy completion [17] and preoperative chemotherapy [41]. Our study follows up on these findings.…”

Section: Chemotherapymentioning

confidence: 66%

Tumor biology in older breast cancer patients – What is the impact on survival stratified for guideline adherence? A retrospective multi-centre cohort study of 5378 patients

et al. 2015

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Section: Chemotherapymentioning

confidence: 66%

Tumor biology in older breast cancer patients – What is the impact on survival stratified for guideline adherence? A retrospective multi-centre cohort study of 5378 patients

et al. 2015

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“…This has occurred in diverse clinical contexts, including undergoing biologic therapy for rheumatoid arthritis,(12) adhering to antipsychotic(13) and antidepressant(14) medications, and initiating adjuvant chemotherapy for breast cancer. (15)…”

Section: Introductionmentioning

confidence: 99%

Spontaneous mental associations with the words “side effect”: Implications for informed and shared decision making

Izadi

Pachur

Wheeler

et al. 2017

Patient Education and Counseling

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Objective To gain insight into patients’ medical decisions by exploring the content of laypeople’s spontaneous mental associations with the term “side effect.” Methods An online cross-sectional survey asked 144 women aged 40–74, “What are the first three things you think of when you hear the words ‘side effect?’” Data were analyzed using content analysis, chi-square, and Fisher’s exact tests. Results 17 codes emerged and were grouped into 4 themes and a Miscellaneous category: Health Problems (70.8% of participants), Decision-Relevant Evaluations (52.8%), Negative Affect (30.6%), Practical Considerations (18.1%) and Miscellaneous (9.7%). The 4 most frequently identified codes were: Evaluating Risks (36.1%), Health Problems-Specific Symptoms (35.4%), Health Problems-General Terms (32.6%), and Negative Affect-Strong (19.4%). Code and theme frequencies were generally similar across demographic groups (ps>0.05). Conclusion The term “side effect” spontaneously elicited comments related to identifying health problems and expressing negative emotions. This might explain why the mere possibility of side effects triggers negative affect for people making medical decisions. Some respondents also mentioned decision-relevant evaluations and practical considerations in response to side effects. Practice Implications Addressing commonly-held associations and acknowledging negative affects provoked by side effects are first steps healthcare providers can take towards improving informed and shared patient decision making.

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“…Whereas some patients agree to treatment regardless of the number or toxicity of side effects [7, 8], others are reluctant to agree to potentially life-saving therapies. This has been demonstrated in many contexts, including taking adjuvant chemotherapy for breast cancer [9], undergoing biologic therapy for rheumatoid arthritis [10], and adhering to antidepressant medication [11]. …”

Section: Introductionmentioning

confidence: 99%

Side Effect Perceptions and Their Impact on Treatment Decisions in Women

2016

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Background Side effects prompt some patients to forego otherwise-beneficial therapies. This study explored which characteristics make side effects particularly aversive. Methods We used a psychometric approach, originating from research on risk perception, to identify the factors (or components) underlying side effect perceptions. Women (N=149) aged 40–74 were recruited from a patient registry to complete an online experiment. Participants were presented with hypothetical scenarios in which an effective and necessary medication conferred a small risk of a single side effect (e.g., nausea, dizziness). They rated a broad range of side effects on several characteristics (e.g., embarrassing, treatable). In addition, we collected four measures of aversiveness for each side effect: choosing to take the medication, willingness to pay to avoid the side effect (WTP), negative affective attitude associated with the side effect, and how each side effect ranks among others in terms of undesirability. A principle-components analysis (PCA) was used to identify the components underlying side effect perceptions. Then, for each aversiveness measure separately, regression analyses were used to determine which components predicted differences in aversiveness among the side effects. Results The PCA revealed four components underlying side effect perceptions: affective challenge (e.g., frightening), social challenge (e.g., disfiguring), physical challenge (e.g., painful), and familiarity (e.g., common). Side effects perceived as affectively and physically challenging elicited the highest levels of aversiveness across all four measures. Conclusions Understanding what side effect characteristics are most aversive may inform interventions to improve medical decisions and facilitate the translation of novel biomedical therapies into clinical practice.

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Adjuvant chemotherapy in elderly women with breast cancer: patients' perspectives on information giving and decision making

Cited by 43 publications

References 36 publications

Tumor biology in older breast cancer patients – What is the impact on survival stratified for guideline adherence? A retrospective multi-centre cohort study of 5378 patients

Tumor biology in older breast cancer patients – What is the impact on survival stratified for guideline adherence? A retrospective multi-centre cohort study of 5378 patients

Spontaneous mental associations with the words “side effect”: Implications for informed and shared decision making

Side Effect Perceptions and Their Impact on Treatment Decisions in Women

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