Jenna L Morgan1, Maria Burton2, Karen Collins2, Kate J Lifford3, Thompson G Robinson4, Kwok-Leung Cheung5, Riccardo Audisio6, Malcolm W Reed1, Lynda Wyld1. 1. Academic Unit of Surgical Oncology, University of Sheffield Medical School, Beech Hill Road, Sheffield, UK. 2. Centre for Health and Social Care Research, Sheffield Hallam University, Collegiate Crescent, Sheffield, UK. 3. Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff, UK. 4. University of Leicester, Department of Cardiovascular Sciences, Robert Kilpatrick Clinical Sciences Building, Leicester, UK. 5. School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Uttoxeter Road, Derby, UK. 6. Department of Surgery, University of Liverpool, St Helens Teaching Hospital, Marshalls Cross Road, St Helens, UK.
Abstract
OBJECTIVE: Primary endocrine therapy (PET) is an alternative to surgery for oestrogen receptor positive operable breast cancer in some older women. However the decision to offer PET involves complex trade-offs and is influenced by both patient choice and healthcare professional (HCP) preference. This study aimed to compare the views of patients and HCPs about this decision and explore decision-making (DM) preferences and whether these are taken into account during consultations. METHODS: This multicentre, UK, mixed methods study had three components: (a) questionnaires to older women undergoing counseling about breast cancer treatment options which assessed their DM preferences and realities; (b) qualitative interviews with older women with operable breast cancer offered a choice of either surgery or PET and (c) qualitative interviews with HCPs (both of which focused on DM preferences in this setting). RESULTS: Thirty-three patients and 34 HCPs were interviewed. A range of opinions about patient involvement in DM were identified. Patients indicated varying preferences for DM involvement which were variably taken into account by HCPs. These qualitative findings were broadly supported by the questionnaire results. Most patients (536/729; 73.5%) achieved their preferred DM style; however, the remainder felt that their DM preferences had not been taken into consideration. CONCLUSIONS: These results suggest that whilst many older women achieve their desired level of DM engagement, some do not, raising the possibility that they may be making choices which are not concordant with their treatment preferences.
OBJECTIVE: Primary endocrine therapy (PET) is an alternative to surgery for oestrogen receptor positive operable breast cancer in some older women. However the decision to offer PET involves complex trade-offs and is influenced by both patient choice and healthcare professional (HCP) preference. This study aimed to compare the views of patients and HCPs about this decision and explore decision-making (DM) preferences and whether these are taken into account during consultations. METHODS: This multicentre, UK, mixed methods study had three components: (a) questionnaires to older women undergoing counseling about breast cancer treatment options which assessed their DM preferences and realities; (b) qualitative interviews with older women with operable breast cancer offered a choice of either surgery or PET and (c) qualitative interviews with HCPs (both of which focused on DM preferences in this setting). RESULTS: Thirty-three patients and 34 HCPs were interviewed. A range of opinions about patient involvement in DM were identified. Patients indicated varying preferences for DM involvement which were variably taken into account by HCPs. These qualitative findings were broadly supported by the questionnaire results. Most patients (536/729; 73.5%) achieved their preferred DM style; however, the remainder felt that their DM preferences had not been taken into consideration. CONCLUSIONS: These results suggest that whilst many older women achieve their desired level of DM engagement, some do not, raising the possibility that they may be making choices which are not concordant with their treatment preferences.
Authors: Sascha M Keij; Joyce E de Boer; Anne M Stiggelbout; Wändi Bruine de Bruin; Ellen Peters; Saïda Moaddine; Marleen Kunneman; Arwen H Pieterse Journal: BMJ Open Date: 2022-05-24 Impact factor: 3.006
Authors: Martine T E Puts; Schroder Sattar; Kara McWatters; Katherine Lee; Michael Kulik; Mary-Ellen MacDonald; Raymond Jang; Eitan Amir; Monika K Krzyzanowska; Natasha Leighl; Margaret Fitch; Anthony M Joshua; Padraig Warde; Ann E Tourangeau; Shabbir M H Alibhai Journal: Support Care Cancer Date: 2016-11-09 Impact factor: 3.603