Literature DB >> 12697850

Helping patients make informed choices: a randomized trial of a decision aid for adjuvant chemotherapy in lymph node-negative breast cancer.

Timothy Whelan1, Carol Sawka, Mark Levine, Amiram Gafni, Leonard Reyno, Andrew Willan, Jim Julian, Susan Dent, Hakam Abu-Zahra, Edmond Chouinard, Richard Tozer, Kathleen Pritchard, Ilona Bodendorfer.   

Abstract

BACKGROUND: In recent years, patients have indicated a desire for more information about their disease and to be involved in making decisions about their care. We developed an aid called the "Decision Board" to help clinicians inform patients with lymph node-negative breast cancer of the risks and benefits of adjuvant chemotherapy. We determined whether adding the Decision Board to the medical consultation improved patient knowledge and satisfaction compared with the medical consultation alone.
METHODS: Between October 1995 and March 2000, 176 women with lymph node-negative breast cancer who were candidates for adjuvant chemotherapy were randomly assigned to receive the Decision Board plus the medical consultation (83 patients) or the medical consultation alone (93 patients). One week after the consultation, patients completed a questionnaire assessing their knowledge about breast cancer and chemotherapy. Satisfaction with decision making was assessed 1 week and 3, 6, and 12 months after randomization, and differences between groups were analyzed by a repeated measures analysis of variance. All statistical tests were two-sided.
RESULTS: Patients in the Decision Board arm were better informed about breast cancer and adjuvant chemotherapy than patients in the control arm (mean knowledge score = 80.2 [on a scale of 0-100], 95% confidence interval [CI] = 77.1 to 83.3, and 71.7, 95% CI = 69.0 to 74.4, respectively; P<.001). Over the entire study period, satisfaction with decision making was higher for patients in the Decision Board arm than for patients in the control arm (P =.032). There was no statistically significant difference between the two groups in the number of patients who chose adjuvant chemotherapy (77% and 70% for patients in the Decision Board arm and those in the control arm, respectively; P =.303).
CONCLUSION: When making decisions regarding adjuvant chemotherapy, patients with early breast cancer who had been exposed to the Decision Board had better knowledge of the disease and treatment options and greater satisfaction with their decision making than those who received the standard consultation.

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Year:  2003        PMID: 12697850     DOI: 10.1093/jnci/95.8.581

Source DB:  PubMed          Journal:  J Natl Cancer Inst        ISSN: 0027-8874            Impact factor:   13.506


  63 in total

Review 1.  Patients' perceptions of sharing in decisions: a systematic review of interventions to enhance shared decision making in routine clinical practice.

Authors:  France Légaré; Stéphane Turcotte; Dawn Stacey; Stéphane Ratté; Jennifer Kryworuchko; Ian D Graham
Journal:  Patient       Date:  2012       Impact factor: 3.883

2.  Predictors and outcomes of feeling of insufficient consultation time in cancer care in Korea: results of a nationwide multicenter survey.

Authors:  Dong Wook Shin; Jae-Hyun Park; Eun-Jung Shim; Myung-Il Hahm; Jong-Hyock Park; Eun-Cheol Park
Journal:  Support Care Cancer       Date:  2011-11-09       Impact factor: 3.603

3.  Collaborative/active participation per se does not decrease anxiety in breast cancer.

Authors:  Zsuzsanna Kahán; Katalin Varga; Rita Dudás; Tibor Nyári; László Thurzó
Journal:  Pathol Oncol Res       Date:  2006-06-24       Impact factor: 3.201

4.  A shared treatment decision-making approach between patients with chronic conditions and their clinicians: the case of diabetes.

Authors:  Victor M Montori; Amiram Gafni; Cathy Charles
Journal:  Health Expect       Date:  2006-03       Impact factor: 3.377

5.  Health Care Disparities Among English-Speaking and Spanish-Speaking Women With Pelvic Organ Prolapse at Public and Private Hospitals: What Are the Barriers?

Authors:  Alexandriah N Alas; Gena C Dunivan; Cecelia K Wieslander; Claudia Sevilla; Biatris Barrera; Rezoana Rashid; Sally Maliski; Karen Eilber; Rebecca G Rogers; Jennifer Tash Anger
Journal:  Female Pelvic Med Reconstr Surg       Date:  2016 Nov/Dec       Impact factor: 2.091

Review 6.  Decision making and cancer.

Authors:  Valerie F Reyna; Wendy L Nelson; Paul K Han; Michael P Pignone
Journal:  Am Psychol       Date:  2015 Feb-Mar

7.  Decisional support throughout the cancer journey for older women diagnosed with early stage breast cancer: a single institutional study.

Authors:  Roseanna Presutti; Laura D'Alimonte; Merrylee McGuffin; Hanbert Chen; Edward Chow; Jean-Philippe Pignol; Lisa Di Prospero; Mary Doherty; Alex Kiss; Jennifer Wong; Justin Lee; Stanley Liu; Ellen Warner; Maureen Trudeau; Deb Feldman-Stewart; Tamara Harth; Ewa Szumacher
Journal:  J Cancer Educ       Date:  2014-03       Impact factor: 2.037

8.  A model building exercise of mortality risk for Taiwanese women with breast cancer.

Authors:  Tsai W Chang; Yao L Kuo
Journal:  BMC Med Inform Decis Mak       Date:  2010-08-19       Impact factor: 2.796

9.  The impact of thyroid cancer and post-surgical radioactive iodine treatment on the lives of thyroid cancer survivors: a qualitative study.

Authors:  Anna M Sawka; David P Goldstein; James D Brierley; Richard W Tsang; Lorne Rotstein; Shereen Ezzat; Sharon Straus; Susan R George; Susan Abbey; Gary Rodin; Mary Ann O'Brien; Amiram Gafni; Lehana Thabane; Jeannette Goguen; Asima Naeem; Lilian Magalhaes
Journal:  PLoS One       Date:  2009-01-14       Impact factor: 3.240

10.  Oncologist use of the Adjuvant! model for risk communication: a pilot study examining patient knowledge of 10-year prognosis.

Authors:  Jeffrey K Belkora; Hope S Rugo; Dan H Moore; David W Hutton; Daniel F Chen; Laura J Esserman
Journal:  BMC Cancer       Date:  2009-04-28       Impact factor: 4.430

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