Empowering patients in decision‐making in radiation oncology – can we do better?

Leech, Michelle; Katz, Matthew S.; Kaźmierska, Joanna; McCrossin, Julie; Turner, Sandra

doi:10.1002/1878-0261.12675

Cited by 13 publications

(8 citation statements)

References 75 publications

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“…GPs often refer patients to surgeons within their existing networks [84], potentially due to limited awareness of the importance of multidisciplinary review by GPs and patients. Lack of familiarity with other treatment modalities [85] and concerns about treatment side effects can also limit referrals for radiation oncology [86,87]. Treatment patterns have been found to vary widely for prostate cancer patients in Australia, for example, depending on whether patients were referred to a radiation oncologist (RO) as well as a surgeon [88] with fewer than 14% consulting with an RO prior to surgery [89].…”

Section: Plos Onementioning

confidence: 99%

Clinical practice guideline adherence in oncology: A qualitative study of insights from clinicians in Australia

et al. 2022

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Background The burden of cancer is large in Australia, and rates of cancer Clinical Practice Guideline (CPG) adherence is suboptimal across various cancers. Methods The objective of this study is to characterise clinician-perceived barriers and facilitators to cancer CPG adherence in Australia. Semi-structured interviews were conducted to collect data from 33 oncology-focused clinicians (surgeons, radiation oncologists, medical oncologists and haematologists). Clinicians were recruited in 2019 and 2020 through purposive and snowball sampling from 7 hospitals across Sydney, Australia, and interviewed either face-to-face in hospitals or by phone. Audio recordings were transcribed verbatim, and qualitative thematic analysis of the interview data was undertaken. Human research ethics committee approval and governance approval was granted (2019/ETH11722, #52019568810127). Results Five broad themes and subthemes of key barriers and facilitators to cancer treatment CPG adherence were identified: Theme 1: CPG content; Theme 2: Individual clinician and patient factors; Theme 3: Access to, awareness of and availability of CPGs; Theme 4: Organisational and cultural factors; and Theme 5: Development and implementation factors. The most frequently reported barriers to adherence were CPGs not catering for patient complexities, being slow to be updated, patient treatment preferences, geographical challenges for patients who travel large distances to access cancer services and limited funding of CPG recommended drugs. The most frequently reported facilitators to adherence were easy accessibility, peer review, multidisciplinary engagement or MDT attendance, and transparent CPG development by trusted, multidisciplinary experts. CPGs provide a reassuring framework for clinicians to check their treatment plans against. Clinicians want cancer CPGs to be frequently updated utilising a wiki-like process, and easily accessible online via a comprehensive database, coordinated by a well-trusted development body. Conclusion Future implementation strategies of cancer CPGs in Australia should be tailored to consider these context-specific barriers and facilitators, taking into account both the content of CPGs and the communication of that content. The establishment of a centralised, comprehensive, online database, with living wiki-style cancer CPGs, coordinated by a well-funded development body, along with incorporation of recommendations into point-of-care decision support would potentially address many of the issues identified.

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Section: Plos Onementioning

confidence: 99%

Clinical practice guideline adherence in oncology: A qualitative study of insights from clinicians in Australia

et al. 2022

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“…Provision of information is essential for shared decision-making and to avoid prioritising evidence-based practice over patients' individual values and preferences. 44 With high numbers of patients failing to receive information about SD, there is a high possibility of treatment-related regret. More SD information discussions during and after EBRT could reduce the observed lack of support and underreporting of sexual side effects for this patient group detailed in recent UK studies.…”

Section: Paucity Of Sd Information Provisionmentioning

confidence: 99%

Adequacy of sexual care information given to prostate cancer patients receiving radical external beam radiotherapy

Greenwood-Wilson

Bridge

2022

J Radiother Pract

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Background: Despite the acknowledged value of providing prostate radiotherapy patients with sexual dysfunction (SD) information, there is little evidence related to patient perceptions of this or the extent to which information is provided to them. This study aimed to critically evaluate the quality and format of SD information given to patients before, during and after radical EBRT to treat prostate cancer. Method: Members of UK prostate cancer support groups were asked to complete an anonymous online survey tool seeking opinions of the SD information they were given before, during and after external beam radiotherapy (EBRT). Results: There were 56 responses to the survey with over 42% of respondents reporting that they had not received any SD information. Of those who did, 78·1% (25/32) received information before the start of EBRT. Physicians were the most involved in the provision of SD information, with nurses and therapeutic radiographers being underutilised. Responses were mostly negative, or neutral regarding the quality of SD information and the information received about impact on relationships, psychological and emotional health. Many participants wanted more information and support. Conclusion: This study demonstrates that prostate cancer patients who have undergone radical EBRT have not received adequate information relating to potential sexual function side effects and the psychological and emotional effects of SD. This information should be included in verbal and written information provided at all stages of the radiotherapy pathway.

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“…Nevertheless, shared decision making can be a very complex process. Indeed, some patients may not wish to participate in choosing their own treatment (Leech et al, 2020). Moreover, information needs of cancer patients can be very heterogeneous and health professionals may not be completely aware on the topics of most importance for patients (Ruesch et al, 2014).…”

Section: Radiation Oncology In Managing Early-stage Cancersmentioning

confidence: 99%

Role of radiation oncology in modern multidisciplinary cancer treatment

et al. 2020

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Cancer care is moving from a disease-focused management toward a patient-centered tailored approach. Multidisciplinary management that aims to define individual, optimal treatment strategies through shared decision making between healthcare professionals and patient is a fundamental aspect of high-quality cancer care and often includes radiation oncology. Advances in technology and radiobiological research allow to deliver ever more tailored radiation treatments in an ever easier and faster way, thus improving the efficacy, safety, and accessibility of radiation therapy. While these changes are improving quality of cancer care, they are also enormously increasing complexity of decision making, thus challenging the ability to deliver quality affordable cancer care. In this review, we provide an updated outline of the role of radiation oncology in the modern multidisciplinary treatment of cancer. Particularly, we focus on the way some developments in key areas of cancer management are challenging multidisciplinary cancer care in the different clinical settings of early, locally advanced, and metastatic disease, thus highlighting some priority areas of research.

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Empowering patients in decision‐making in radiation oncology – can we do better?

Cited by 13 publications

References 75 publications

Clinical practice guideline adherence in oncology: A qualitative study of insights from clinicians in Australia

Clinical practice guideline adherence in oncology: A qualitative study of insights from clinicians in Australia

Adequacy of sexual care information given to prostate cancer patients receiving radical external beam radiotherapy

Role of radiation oncology in modern multidisciplinary cancer treatment

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