Decision aids for cancer survivors’ engagement with survivorship care services after primary treatment: a systematic review

Abstract

Purpose To elucidate existing decision aids (DAs) in supporting cancer survivors’ decisions to engage in cancer survivorship care services after primary treatment. Secondary objectives are to assess the DA acceptability, impact of DAs, and implementation barriers. Methods Databases (PubMed, Embase, PsycINFO, CINAHL) were searched to collect publications from inception through September 2021. Studies describing the development or evaluation of DAs used for survivorship care services after primary cancer treatment were included. Article selection and critical appraisal were conducted independently by two authors. Results We included 16 studies that described 13 DAs and addressed multiple survivorship care domains: prevention of recurrence/new cancers in Hodgkin lymphoma survivors and breast cancer gene mutation carriers, family building options, health insurance plans, health promotion (substance use behavior, cardiovascular disease risk reduction), advanced care planning, and post-treatment follow-up intensity. The electronic format was used to design most DAs for self-administration. The content presentation covered decisional context, options, and value clarification exercises. DAs were acceptable and associated with higher knowledge but presented inconclusive decisional outcomes. Implementation barriers included lack of design features for connectivity to care, low self-efficacy, and low perceived DA usefulness among healthcare professionals. Other survivor characteristics included age, literacy, preferred timing, and setting. Conclusions A diverse range of DAs exists in survivorship care services engagement with favorable knowledge outcomes. Future work should clarify the impact of DAs on decisional outcomes. Implications for Cancer Survivors DA characterization and suggestions for prospective developers could enhance support for cancer survivors encountering complex decisions throughout the survivorship continuum.

Biographical Renewal and its Facilitators in Cancer Survivorship: A Conceptual Paper

“…In this view, patient autonomy is a widely recognised practice in treatment decision-making [ 20 , 21 ] and survivorship care. [ 22 ]…”

The effects of decision aids for genetic counselling among people considering genetic testing: A systematic review

“…All these would enable the healthcare users to make their informed choice on which treatment they should undergo. Previous reviews had demonstrated the effectiveness of decision aids in improving knowledge of healthcare users about the health condition they faced, and reducing their decisional conflict that they had in choosing treatment options, although variations did exist in the effect of decision aid utilisation on these outcomes across studies (Alarcon‐Ruiz et al, 2022; Ke et al, 2022; Knops et al, 2013; Paskins et al, 2020; Violette et al, 2015). These findings suggest that decision aids may help enhance the effectiveness of counselling services involving impartation of knowledge on healthcare services to counsellees and enable them to make informed choices on the utilisation of these services.…”