Health care professionals' perspectives on shared decision making supported by personalised‐risk‐for‐recurrences‐calculations regarding surveillance after breast cancer

Abstract

Objective: Breast cancer patients for whom less intensive surveillance is sufficient can be identified based on the risk for locoregional recurrences (LRRs). This study explores health care professionals' (HCPs) perspectives on less intensive surveillance, preferences for shared decision-making (SDM) about surveillance and perspectives on the use of patients' estimated personal risk for LRRs in decision-making about surveillance.Methods: We conducted semi-structured interviews with 21 HCPs providing followup care for breast cancer patients in seven Dutch teaching hospitals (Santeon hospitals).Results: HCPs were predominantly positive about less intensive surveillance for women with a low risk for recurrences. They mentioned important prerequisites such as clearly defined surveillance schedules based on risk categories, information provision and communication support for patients and HCPs. Most HCPs supported SDM about surveillance and were positive about using patients' estimated personal risk for LRRs. HCPs specified prerequisites such as clear visualisation and explanation of risk information, attention for fear of cancer recurrence (FCR) and defined surveillance schedules for specific risk groups. Conclusion:Mentioned prerequisites for less intensive surveillance need to be accounted for. Information needs and existing misconceptions need to be addressed.Outcome information regarding risks for LRRs and FCR can enrich the SDM process about surveillance.

Supporting Shared Decision-making About Surveillance After Breast Cancer With Personalized Recurrence Risk Calculations: Development of a Patient Decision Aid Using the International Patient Decision AIDS Standards Development Process in Combination With a Mixed Methods Design

“…Specific information needs, preferences, and prerequisites for SDM about personalized posttreatment surveillance were gathered and translated into requirements for the PtDA (see Step 4: Requirements ). More detailed results of the needs assessment studies can be found in 2 previously published papers [ 6 , 24 ].…”

“…Transcripts of all interviews were coded by independent coders (JA and CD) and analyzed using the “framework methodology” [ 23 ], which consists of a combination of inductive and deductive approaches: in each of the main topics, the coders inductively searched for themes that emerged from the data. Further details regarding the method of the needs assessment studies can be found in 2 previously published papers [ 6 , 24 ].…”