BACKGROUND: The first step in shared decision making (SDM) is creating choice awareness. This is particularly relevant in consultations concerning preference-sensitive treatment decisions, e.g. those addressing (neo-)adjuvant therapy. Awareness can be achieved by explicitly stating, as the 'reason for encounter', that a treatment decision needs to be made. It is unknown whether oncologists express such reason for encounter. This study aims to establish: 1) if 'making a treatment decision' is stated as a reason for the encounter and if not, what other reason for encounter is provided; and 2) whether mentioning that a treatment decision needs to be made is associated with enhanced patient involvement in decision making. MATERIAL AND METHODS: Consecutive first consultations with: 1) radiation oncologists and rectal cancer patients; or 2) medical oncologists and breast cancer patients, facing a preference-sensitive treatment decision, were audiotaped. The tapes were transcribed and coded using an instrument developed for the study. Oncologists' involvement of patients in decision making was coded using the OPTION-scale. RESULTS: Oncologists (N = 33) gave a reason for encounter in 70/100 consultations, usually (N = 52/70, 74%) at the start of the consultation. The reason for encounter stated was 'making a treatment decision' in 3/100 consultations, and 'explaining treatment details' in 44/100 consultations. The option of foregoing adjuvant treatment was not explicitly presented in any consultation. Oncologist' involvement of patients in decision making was below baseline (Md OPTION-score = 10). Given the small number of consultations in which the need to make a treatment decision was stated, we could not investigate the impact thereof on patient involvement. CONCLUSION: This study suggests that oncologists rarely express that a treatment decision needs to be made in consultations concerning preference-sensitive treatment decisions. Therefore, patients might not realize that foregoing (neo-)adjuvant treatment is a viable choice. Oncologists miss a crucial opportunity to facilitate SDM.
BACKGROUND: The first step in shared decision making (SDM) is creating choice awareness. This is particularly relevant in consultations concerning preference-sensitive treatment decisions, e.g. those addressing (neo-)adjuvant therapy. Awareness can be achieved by explicitly stating, as the 'reason for encounter', that a treatment decision needs to be made. It is unknown whether oncologists express such reason for encounter. This study aims to establish: 1) if 'making a treatment decision' is stated as a reason for the encounter and if not, what other reason for encounter is provided; and 2) whether mentioning that a treatment decision needs to be made is associated with enhanced patient involvement in decision making. MATERIAL AND METHODS: Consecutive first consultations with: 1) radiation oncologists and rectal cancerpatients; or 2) medical oncologists and breast cancerpatients, facing a preference-sensitive treatment decision, were audiotaped. The tapes were transcribed and coded using an instrument developed for the study. Oncologists' involvement of patients in decision making was coded using the OPTION-scale. RESULTS: Oncologists (N = 33) gave a reason for encounter in 70/100 consultations, usually (N = 52/70, 74%) at the start of the consultation. The reason for encounter stated was 'making a treatment decision' in 3/100 consultations, and 'explaining treatment details' in 44/100 consultations. The option of foregoing adjuvant treatment was not explicitly presented in any consultation. Oncologist' involvement of patients in decision making was below baseline (Md OPTION-score = 10). Given the small number of consultations in which the need to make a treatment decision was stated, we could not investigate the impact thereof on patient involvement. CONCLUSION: This study suggests that oncologists rarely express that a treatment decision needs to be made in consultations concerning preference-sensitive treatment decisions. Therefore, patients might not realize that foregoing (neo-)adjuvant treatment is a viable choice. Oncologists miss a crucial opportunity to facilitate SDM.
Authors: Joschka Haltaufderheide; Sebastian Wäscher; Bernhard Bertlich; Jochen Vollmann; Anke Reinacher-Schick; Jan Schildmann Journal: Oncologist Date: 2018-09-06
Authors: Jordan M Cloyd; Sarah Hyman; Tanya Huwig; Christina Monsour; Heena Santry; Celia Wills; Allan Tsung; John F P Bridges Journal: Support Care Cancer Date: 2020-10-08 Impact factor: 3.603
Authors: Fania R Gärtner; Hanna Bomhof-Roordink; Ian P Smith; Isabelle Scholl; Anne M Stiggelbout; Arwen H Pieterse Journal: PLoS One Date: 2018-02-15 Impact factor: 3.240
Authors: Lena Stevens; Zachary J Brown; Ryan Zeh; Christina Monsour; Sharla Wells-Di Gregorio; Heena Santry; Aslam M Ejaz; Timothy Michael Pawlik; Jordan M Cloyd Journal: World J Gastrointest Oncol Date: 2022-06-15
Authors: Naykky Singh Ospina; Kari A Phillips; Rene Rodriguez-Gutierrez; Ana Castaneda-Guarderas; Michael R Gionfriddo; Megan E Branda; Victor M Montori Journal: J Gen Intern Med Date: 2018-07-02 Impact factor: 5.128
Authors: Marieke M T Kuijpers; Haske van Veenendaal; Vivian Engelen; Ella Visserman; Eveline A Noteboom; Anne M Stiggelbout; Anne M May; Niek de Wit; Elsken van der Wall; Charles W Helsper Journal: Eur J Cancer Care (Engl) Date: 2021-11-02 Impact factor: 2.328