PURPOSE: To develop a patient decision aid (PtDA) for older women with Stage I, pathologically node negative, estrogen receptor-positive progesterone receptor-positive breast cancer who are considering adjuvant radiotherapy after lumpectomy and to examine its impact on patients' decision making. METHODS AND MATERIALS: A PtDA was developed and evaluated in three steps according to the Ottawa Decision Support Framework: (1) needs assessment (n = 16); (2) Pilot I to examine PtDA acceptability (n = 12); and (3) Pilot II, a pretest posttest (n = 38) with older women with estrogen receptor-positive progesterone receptor-positive breast cancer after lumpectomy who were receiving adjuvant radiation therapy. Measures included patients' satisfaction with the PtDA, self-reported decisional conflict, level of distress, treatment-related knowledge, and choice predisposition. RESULTS: The PtDA is a booklet that details each adjuvant treatment option's benefits, risks, and side effects tailored to the patient's clinical profile; includes a values clarification exercise; and includes steps to guide patients towards their decision. On the basis of qualitative comments and satisfaction ratings, all women thought that the PtDA was helpful and informative. In comparison with their baseline scores, patients had a statistically significant (p < 0.05) reduction in decisional conflict (adjusted mean difference [AMD], -7.18; 95% confidence interval [CI], -13.50 to 12.59); increased clarity of the benefits and risks (AMD, -10.86; CI, -20.33 to 21.49); and improved general treatment knowledge (AMD, 8.99; CI, 2.88-10.28) after using the PtDA. General trends were also reported in the patients' choice predisposition scores that suggested potential differences in treatment decision after PtDA use. CONCLUSIONS: This study provides evidence that this PtDA may be a helpful educational tool for this group of women. The quality of care for older breast cancer patients may be enhanced by the use of a tailored PtDA to help patients be better informed about their treatment options.
PURPOSE: To develop a patient decision aid (PtDA) for older women with Stage I, pathologically node negative, estrogen receptor-positive progesterone receptor-positive breast cancer who are considering adjuvant radiotherapy after lumpectomy and to examine its impact on patients' decision making. METHODS AND MATERIALS: A PtDA was developed and evaluated in three steps according to the Ottawa Decision Support Framework: (1) needs assessment (n = 16); (2) Pilot I to examine PtDA acceptability (n = 12); and (3) Pilot II, a pretest posttest (n = 38) with older women with estrogen receptor-positive progesterone receptor-positive breast cancer after lumpectomy who were receiving adjuvant radiation therapy. Measures included patients' satisfaction with the PtDA, self-reported decisional conflict, level of distress, treatment-related knowledge, and choice predisposition. RESULTS: The PtDA is a booklet that details each adjuvant treatment option's benefits, risks, and side effects tailored to the patient's clinical profile; includes a values clarification exercise; and includes steps to guide patients towards their decision. On the basis of qualitative comments and satisfaction ratings, all women thought that the PtDA was helpful and informative. In comparison with their baseline scores, patients had a statistically significant (p < 0.05) reduction in decisional conflict (adjusted mean difference [AMD], -7.18; 95% confidence interval [CI], -13.50 to 12.59); increased clarity of the benefits and risks (AMD, -10.86; CI, -20.33 to 21.49); and improved general treatment knowledge (AMD, 8.99; CI, 2.88-10.28) after using the PtDA. General trends were also reported in the patients' choice predisposition scores that suggested potential differences in treatment decision after PtDA use. CONCLUSIONS: This study provides evidence that this PtDA may be a helpful educational tool for this group of women. The quality of care for older breast cancerpatients may be enhanced by the use of a tailored PtDA to help patients be better informed about their treatment options.
Authors: M L Sautter-Bihl; F Sedlmayer; W Budach; J Dunst; P Feyer; R Fietkau; W Haase; W Harms; C Rödel; R Souchon; F Wenz; R Sauer Journal: Strahlenther Onkol Date: 2012-10-28 Impact factor: 3.621
Authors: Anik M C Giguere; Elina Farmanova; Jayna M Holroyd-Leduc; Sharon E Straus; Robin Urquhart; Valerie Carnovale; Erik Breton; Selynne Guo; Nandini Maharaj; Pierre J Durand; France Légaré; Alexis F Turgeon; Michèle Aubin Journal: BMC Geriatr Date: 2018-11-26 Impact factor: 3.921
Authors: Ruben Vromans; Kim Tenfelde; Steffen Pauws; Mies van Eenbergen; Ingeborg Mares-Engelberts; Galina Velikova; Lonneke van de Poll-Franse; Emiel Krahmer Journal: Breast Cancer Res Treat Date: 2019-07-24 Impact factor: 4.872
Authors: Indrani S Bhattacharya; Joanne S Haviland; Charlotte E Coles; Judith M Bliss; Lesley Turner; Hilary Stobart; Ada Balasopoulou; Liba Stones; Anna M Kirby; Cliona C Kirwan Journal: Trials Date: 2021-06-14 Impact factor: 2.279
Authors: Mirjam M Garvelink; Moniek M ter Kuile; Anne M Stiggelbout; Marieke de Vries Journal: BMC Med Inform Decis Mak Date: 2014-08-09 Impact factor: 2.796
Authors: W Savelberg; T van der Weijden; L Boersma; M Smidt; C Willekens; A Moser Journal: BMC Med Inform Decis Mak Date: 2017-08-01 Impact factor: 2.796
Authors: D B Raphael; N S Russell; J M Immink; P G Westhoff; M C Stenfert Kroese; M R Stam; L M van Maurik; H J G D van den Bongard; J H Maduro; M G A Sattler; T van der Weijden; L J Boersma Journal: Breast Date: 2020-04-06 Impact factor: 4.380