Making hard choices easier: a prospective, multicentre study to assess the efficacy of a fertility-related decision aid in young women with early-stage breast cancer

Peate, Michelle; Meiser, Bettina; Cheah, Benjamin C.; Saunders, Christobel; Butow, Phyllis; Thewes, Belinda; Hart, Roger; Phillips, Kelly‐Anne; Hickey, Martha; Friedlander, Michael

doi:10.1038/bjc.2012.61

Cited by 142 publications

(182 citation statements)

References 46 publications

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“…Unlike other studies (Peate et al, 2012;Stacey et al, 2014) the knowledge scores in our study did not differ between groups. However, the information in the brochures and DA was highly overlapping, and women in both randomization groups read the brochures.…”

Section: Discussioncontrasting

confidence: 99%

“…Fourth, both information sources led to a significant increase in knowledge between baseline and follow-up, comparable to other studies (Peate et al, 2012). Unlike other studies (Peate et al, 2012;Stacey et al, 2014) the knowledge scores in our study did not differ between groups.…”

Section: Discussionsupporting

confidence: 85%

“…Fifth, when we compared our results with regard to knowledge and DC to previous data of a historical group of women who only received counselling consultation, both brochures and our DA had more favourable scores on DC and knowledge than in women who received counselling only Peate et al, 2012). Therefore, the benefit of any additional information with regard to knowledge and feeling supported in DM about FP is clear .…”

Section: Discussionmentioning

confidence: 49%

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Feasibility and effects of a decision aid about fertility preservation

et al. 2016

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This paper reports on the feasibility and preliminary effects of a decision aid (DA) about female fertility preservation (FP). We conducted a pilot multicentre randomized controlled trial of women with breast cancer aged 18-40 who were randomized to brochures or the DA. Over 18 months, 62 women were eligible, of which 42 were invited by their healthcare provider (74%) to participate in the study. A total of 36 women signed up for participation and 26 (72%) were randomized to brochures (n ¼ 13) or the DA (n ¼ 13). In both groups, many women (87%) read the brochures and eight women used all available brochures. In the intervention group, 7/13 women logged in to the DA. Women who received brochures had slightly less decisional conflict, whereas knowledge improved in both groups. Our results indicate that both brochures about FP and a detailed DA have beneficial effects with regard to knowledge, but the DA seemed to introduce slightly more decisional conflict (DC) than the brochures. Although we encountered challenges with recruitment, our design and measurements seem feasible and the effects of the information materials seem promising, hence justifying conducting a larger study. ARTICLE HISTORY

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 49%

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Feasibility and effects of a decision aid about fertility preservation

et al. 2016

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“…Multiple strategies exist to address fertility discussions and facilitation of FP referrals including the provision of written materials (51), web-based decision aids (52,53), the development of dedicated clinical programs (54), and the identification of a fertility preservation network with access to infertility expertise at respective oncology centers (54). Whenever possible, team members who have the time and expertise to have the conversations should be identified in order to maximize opportunities for consistent information delivery to patients.…”

Section: Impacts On Discussion Regarding Fpmentioning

confidence: 99%

Fertility preservation in post-pubescent female cancer patients: A practical guideline for clinicians

et al. 2017

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Abstract. Increasing accessibility of fertility preservation (FP) options has permitted women to retain fertility following anticancer therapies. Several published guidelines have made recommendations for FP however their implementation into practice is currently unknown. In this review, we aim to provide oncology clinicians practical information about FP options for post-pubescent female cancer patients and recommendations for care delivery in order to answer preliminary questions and help triage whether FP referral is appropriate. Herein, we present a resource for oncology providers to guide them with FP discussions. Key points that are discussed in this critical review include: i) All cancer patients beginning a new plan of care should be informed of potential fertility risk. ii) If a woman requests further information on FP interventions, referral to a FP clinic should be made. iii) Given the evolving technologies in this area, patients should be informed of those which are proven and unproven, with oocyte and embryo preservation recognized as standard practice. iv) Random start (independent of menstrual cycle day) techniques are available to minimize oncologic treatment delays. v) Specific protocols for ovarian stimulation may be center-specific. vi) There is unlikely an increased cancer recurrence risk as a result of stimulation protocols in women with hormone-sensitive cancers. vii) Lastly, given the absence of consensus in the literature, routine use of GnRH analogs is not recommended for all cancer patients, however may be considered in select cases, such as high-risk women in whom definitive FP is not possible or feasible.

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“…25,26 For example, a recent study of young women with early-stage breast cancer found that, as compared with usual care, women who received the decision aid knew more about their options, were more certain about their decisions, and had less decisional regret. 27 Ironically, the principles of IDM are rarely incorporated in the consent process. A review of consent documents used in 139 clinical trials concluded that most failed to meet international standards for supporting informed decisions, 28 and, with only a few exceptions, 29 the application of IDM to the consent process has not been studied.…”

Section: The Newborn Screening Contextmentioning

confidence: 99%