Linda A Klaassen1, Carmen D Dirksen2, Liesbeth J Boersma3, Ciska Hoving4. 1. Maastricht University, Department of Radiotherapy, GROW School for Oncology and Developmental Biology, CAPHRI Care and Public Health Research Institute, P. O. Box 616, 6200, MD, Maastricht, The Netherlands. Electronic address: l.klaassen@maastrichtuniversity.nl. 2. Maastricht University Medical Centre +, Department of Clinical Epidemiology and Medical Technology Assessment, CAPHRI Care and Public Health Research Institute, P.O. Box 5800, 6202, AZ, Maastricht, The Netherlands. Electronic address: C.Dirksen@mumc.nl. 3. Department of Radiation Oncology (MAASTRO Clinic), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre +, P.O. Box 3035, 6202, NA, Maastricht, The Netherlands. Electronic address: liesbeth.boersma@maastro.nl. 4. Maastricht University, Department of Health Promotion, CAPHRI Care and Public Health Research Institute, P. O. Box 616, 6200, MD, Maastricht, The Netherlands. Electronic address: c.hoving@maastrichtuniversity.nl.
Abstract
OBJECTIVE: A patient decision aid (PtDA), was developed to support breast cancer patients making choices about their aftercare. The aim of this pilot was to test the effects of the PtDA on Shared Decision Making (SDM), Decision Evaluation (DES) in patients, consultation time, choice of aftercare and hospital costs. METHODS: A prospective before-and-after study including a control (no PtDA-usage) and experimental group (PtDA-usage during consultation) was conducted in six hospitals. Patients were offered a choice between intensive (face-to-face consultations) and less intensive (telephonic or on demand consultations) aftercare. All patients filled out three validated questionnaires (baseline (T0), directly after the consultation (T1), three months later (T2)), assessing demographics (T0), SDM(T1) and DES (T1, T2). Hospital costs and choice of aftercare were assessed from the patients' files (T2). Effect sizes ( ɳp2: 0.01 = small; 0.06 = medium; 0.14 = large; φ: 0.1 = small, 0.3 = medium, 0.5 = large) and p-values were calculated using both univariate and multivariate GLMs, a repeated measures GLM and chi-square-tests. RESULTS: A small improvement in SDM ( ɳp2 = 0.02) and an effect ( ɳp2 = 0.10) on DES was found in the experimental group. Significantly more PtDA-users (51% vs. 29%, φ = 0.22) chose less intensive aftercare, leading to a small reduction of hospital costs (122 vs. 92 Euro, ɳp2 = 0.01), and a large increase in average consultation time (12.5 min; ɳp2 = 0.29). CONCLUSION: This pilot study showed promising effects of the PtDA on SDM and hospital costs. The PtDA can be developed further to potentially reduce the increased consultation time.
OBJECTIVE: A patient decision aid (PtDA), was developed to support breast cancerpatients making choices about their aftercare. The aim of this pilot was to test the effects of the PtDA on Shared Decision Making (SDM), Decision Evaluation (DES) in patients, consultation time, choice of aftercare and hospital costs. METHODS: A prospective before-and-after study including a control (no PtDA-usage) and experimental group (PtDA-usage during consultation) was conducted in six hospitals. Patients were offered a choice between intensive (face-to-face consultations) and less intensive (telephonic or on demand consultations) aftercare. All patients filled out three validated questionnaires (baseline (T0), directly after the consultation (T1), three months later (T2)), assessing demographics (T0), SDM(T1) and DES (T1, T2). Hospital costs and choice of aftercare were assessed from the patients' files (T2). Effect sizes ( ɳp2: 0.01 = small; 0.06 = medium; 0.14 = large; φ: 0.1 = small, 0.3 = medium, 0.5 = large) and p-values were calculated using both univariate and multivariate GLMs, a repeated measures GLM and chi-square-tests. RESULTS: A small improvement in SDM ( ɳp2 = 0.02) and an effect ( ɳp2 = 0.10) on DES was found in the experimental group. Significantly more PtDA-users (51% vs. 29%, φ = 0.22) chose less intensive aftercare, leading to a small reduction of hospital costs (122 vs. 92 Euro, ɳp2 = 0.01), and a large increase in average consultation time (12.5 min; ɳp2 = 0.29). CONCLUSION: This pilot study showed promising effects of the PtDA on SDM and hospital costs. The PtDA can be developed further to potentially reduce the increased consultation time.
Authors: Jet W Ankersmid; Jolanda C van Hoeve; Luc J A Strobbe; Yvonne E A van Riet; Cornelia F van Uden-Kraan; Sabine Siesling; Constance H C Drossaert Journal: Eur J Cancer Care (Engl) Date: 2021-08-27 Impact factor: 2.328