Patient decision aids for cancer treatment

Abstract

BACKGROUND: Although patient decision aids (pDAs) are effective, widespread use of pDAs for cancer treatment has not been achieved. The objectives of this study were to perform a systematic review to identify alternate types of decision support interventions (DSIs) for cancer treatment and a meta-analysis to compare the effectiveness of these DSIs to pDAs. METHODS: The inclusion criteria for the study were: 1) all published studies using a randomized, controlled trial design, and 2) DSIs involving treatment decision-making for breast, prostate, colorectal, and/or lung cancer. For this analysis, DSIs were classified as pDAs if: 1) one reported outcome measure mapped onto the International Patient Decision Aids Standards Collaboration effectiveness criterion, and 2) the DSI was evaluated relative to standard consultation. Random effects models were used to compare the effectiveness of pDAs relative to other identified DSIs for reported outcomes. RESULTS: A total of 71 studies were reviewed, and 24 met the inclusion criteria. Overall, there were no significant differences in knowledge, satisfaction, anxiety, or decisional conflict scores between pDAs and other DSIs. CONCLUSIONS: This study showed that the effectiveness of other DSIs, including question prompt lists and audiorecording of the consultation, is similar to pDAs. This is important because it may be that these less complex DSIs may be all that is necessary to

Primary Breast Cancer Decision-making Among Chinese American Women

“…To support quality breast cancer decision-making among Chinese American women, providers need to develop decision support interventions (Spiegle et al, 2013), but these interventions must address the identified sociodemographic barriers and preferred involvement in decision-making. The breast cancer navigator (patient or nurse) and advanced practice nurses are key providers in the breast surgical oncology setting who can provide decision support and coordinate the care for ethnic minority women diagnosed with early-stage breast cancer, with the goal of high-quality breast cancer care.…”

“…Most of the trials with patient decision aids or decision support interventions have resulted in higher satisfaction (Spiegle et al, 2013). However, ethnic minority and low-income women are more likely to have lower satisfaction following treatment decision-making (Lantz et al, 2005).…”

“…Satisfaction is an established outcome in healthcare decisionmaking and has been evaluated in relation to the consultation process (Lam et al, 2014), information received (Sheehan, Sherman, Lam, & Boyages, 2007), the overall decision-making process (Sabo, St-Jacques, & Rayson, 2007), and decision support interventions (Spiegle et al, 2013). Most of the trials with patient decision aids or decision support interventions have resulted in higher satisfaction (Spiegle et al, 2013).…”

Breast cancer patients’ information seeking during surgical consultations: A qualitative, videotape‐based analysis of patients’ questions

“…The provision of patient centered care in oncology contexts centrally involves improving information exchange between providers and patients , one component of which is better understanding, anticipating, and tailoring care around patients’ information needs . The present study is the first to directly observe what U.S. breast cancer patients actually ask surgeons during initial consultations.…”

Parallel multicentre randomised trial of a clinical trial question prompt list in patients considering participation in phase 3 cancer treatment trials

“…Juraskova et al 7 reported successful piloting of a decision aid to assist women considering participation in a breast cancer prevention trial. Spiegle et al 8 performed a systematic review to identify alternative types of decision support interventions (DSIs) for cancer treatment and a meta-analysis to compare the effectiveness of DSIs compared with patient decision aids. The study showed that the effectiveness of other DSIs, including question prompt list (QPLs) and audio recordings of the consultation, is similar to patient decision aids.…”