Key elements of optimal treatment decision-making for surgeons and older patients with colorectal or pancreatic cancer: A qualitative study

Geessink, Noralie H.; Schoon, Yvonne; Herk, Hanneke C.P. van; Goor, Harry van; Rikkert, Marcel G M Olde

doi:10.1016/j.pec.2016.10.013

Cited by 29 publications

(41 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Because of the promising results among PC patients, we recommend to start with this target group. Since the implementation of SDM and screening of the older patient’s context are connected with each other, 7 we advise to deliver both components simultaneously, for example, with help from nurse specialists. Ideally, it would also be investigated which component of the EASY-GO intervention can contribute to what extent.…”

Section: Discussionmentioning

confidence: 99%

“…First, the nurse specialists performed 60 minutes of geriatric screening in all patients aged ≥65 years using the EASYcare instrument, MMSE, GDS-15, and gait speed. Since older CRC/PC patients and their physicians considered “obtaining an overall picture” and “taking into account frailty”, respectively, a key element in optimal decision-making, 7 we introduced the geriatric assessment as part of the EASY-GO intervention. In addition, patients’ goals in life and treatment preferences were discussed.…”

Section: Methodsmentioning

confidence: 99%

“… 4 – 6 For older CRC and PC patients and their families, it is important to understand what they can expect after surgery and how surgery may impact their daily life. 7 To adequately inform older patients, surgeons should integrate information on their physical and psychosocial problems, including the overall frailty. 7 However, this is a difficult task, and while preoperative geriatric assessment is recommended in many oncologic guidelines, it is usually limited to an anesthesiologic risk evaluation about the patient’s fitness for surgery.…”

Section: Introductionmentioning

confidence: 99%

“… 7 To adequately inform older patients, surgeons should integrate information on their physical and psychosocial problems, including the overall frailty. 7 However, this is a difficult task, and while preoperative geriatric assessment is recommended in many oncologic guidelines, it is usually limited to an anesthesiologic risk evaluation about the patient’s fitness for surgery. 8 Non-geriatric physicians are often overwhelmed by the complexity of geriatric patients.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Training surgeons in shared decision-making with cancer patients aged 65 years and older: a pilot study

Geessink¹,

Schoon²,

Rikkert³

et al. 2017

CMAR

Self Cite

View full text Add to dashboard Cite

ObjectiveTreatment decision-making in older patients with colorectal (CRC) or pancreatic cancer (PC) needs improvement. We introduced the EASYcare in Geriatric Onco-surgery (EASY-GO) intervention to optimize the shared decision-making (SDM) process among these patients.MethodsThe EASY-GO intervention comprised a working method with geriatric assessment and SDM training for surgeons. A non-equivalent control group design was used. Newly diagnosed CRC/PC patients aged ≥65 years were included. Primary patient-reported experiences were the quality of SDM (SDM-Q-9, range 0–100), involvement in decision-making (Visual Analog Scale for Involvement in the decision-making process [range 0–10]), satisfaction about decision-making (Visual Analog Scale for Satisfaction concerning the decision-making process [range 0–10]), and decisional regret (Decisional Regret Scale [DRS], range 0–100). Only for DRS, lower scores are better.ResultsA total of 71.4% of the involved consultants and 42.9% of the involved residents participated in the EASY-GO training. Only 4 trained surgeons consulted patients both before (n=19) and after (n=19) training and were consequently included in the analyses. All patient-reported experience measures showed a consistent but non-significant change in the direction of improved decision-making after training. According to surgeons, decisions were significantly more often made together with the patient after training (before, 38.9% vs after, 73.7%, p=0.04). Sub-analyses per diagnosis showed that patient experiences among older PC patients consistent and clinically relevant changed in the direction of improved decision-making after training (SDM-Q-9 +13.4 [95% CI −7.9; 34.6], VAS-I +0.27 [95% CI −1.1; 1.6], VAS-S +0.88 [95% CI −0.5; 2.2], DRS −10.3 [95% CI −27.8; 7.1]).ConclusionThis pilot study strengthens the practical potential of the intervention’s concept among older surgical cancer patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Training surgeons in shared decision-making with cancer patients aged 65 years and older: a pilot study

Geessink¹,

Schoon²,

Rikkert³

et al. 2017

CMAR

Self Cite

View full text Add to dashboard Cite

show abstract

“…On the other hand, this emphasizes the need for SDM among these target groups. Especially among older patients, the presence of a third person during the consultation seems essential, as he or she can support in realizing understanding of the choices to be made and in the decision-making itself (Geessink et al 2017b). However, physicians should be aware that older patients can give socially desirable answers or answers in order to please their family.…”

Section: Sdm Models For Clinical Practicementioning

confidence: 99%

Personalized Medicine and Decision-Making

Geessink¹,

Schoon²,

Rikkert³

2020

Encyclopedia of Gerontology and Population Aging

Self Cite

View full text Add to dashboard Cite

Shared decision‐making with older adults with cancer: Adaptation of a model through literature review and expert opinion

Gans,

Pieterse,

Klapwijk

et al. 2024

Psycho-Oncology

View full text Add to dashboard Cite

ObjectiveTo provide a literature overview of characteristics of Shared Decision Making (SDM) with specific importance to the older adult population with cancer and to tailor an existing model of SDM in patients with cancer to the needs of older adults.MethodsA systematic search of several databases was conducted. Eligible studies described factors influencing SDM concerning cancer treatment with adults aged 65 years or above, with any type of cancer. We included qualitative or mixed‐methods studies. Themes were identified and discussed in an expert panel, including a patient‐representative, until consensus was reached on an adjusted model.ResultsOverall 29 studies were included and nine themes were identified from the literature. The themes related to the importance of goal setting, need for tailored information provision, the role of significant others, uncertainty of evidence, the importance of time during and outside of consultations, the possible ill‐informed preconceptions that health care professionals (HCPs) might have about older adults and the specific competencies they need to engage in the SDM process with older adults. No new themes emerged from discussion with expert panel. This study presents a visual model of SDM with older patients with cancer based on the identified themes.ConclusionsOur model shows key elements that are specific to SDM with older adults. Further research needs to focus on how to educate HCPs on the competencies needed to engage in SDM with older patients, and how to implement the model into everyday practice.

show abstract

Key elements of optimal treatment decision-making for surgeons and older patients with colorectal or pancreatic cancer: A qualitative study

Cited by 29 publications

References 43 publications

Training surgeons in shared decision-making with cancer patients aged 65 years and older: a pilot study

Training surgeons in shared decision-making with cancer patients aged 65 years and older: a pilot study

Personalized Medicine and Decision-Making

Shared decision‐making with older adults with cancer: Adaptation of a model through literature review and expert opinion

Contact Info

Product

Resources

About