Yifan Wang1, Antoinette Anazodo1,2,3, Shanna Logan1,2,3,4. 1. School of Women and Children's Health, Faculty of Medicine, UNSW Sydney, Sydney, Australia. 2. Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia. 3. Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Sydney, Australia. 4. Fertility & Research Centre, Royal Hospital for Women, Sydney, Australia.
Abstract
OBJECTIVE: Despite recommendations internationally for the timely provision of fertility information, cancer patients report unmet information needs, with poor provision and inadequate written information to assist in fertility preservation decision-making. Patient decision aids (PtDAs) may be a useful resource in this setting to inform patients and guide decision-making. A systematic review of the literature on decision aids for fertility preservation in cancer patients would determine the effectiveness of these tools in supporting decision-making about fertility preservation and indicate their current use in clinical care. METHODS: A systematic review was conducted in March 2018, within electronic search databases Medline, EMBASE, PSYCH Info, PubMed, and Web of Science. An initial search identified 718 potentially relevant articles from databases and screening of relevant reference lists. RESULTS: A total of 12 papers, detailing 11 studies with a total of 772 participants, evaluating nine decision aids, were included within the review. PtDAs were shown to significantly increase fertility preservation knowledge and decrease decisional conflict. Overall satisfaction with decision aids was high. Currently, only two reviewed decision aids are available for cancer patients. Another tool has been integrated into a web page, and one implementation study has been completed. CONCLUSIONS: PtDAs can serve as effective complements to current fertility counselling practices by increasing information satisfaction and decision-making outcomes. More research is needed into the appropriateness of these resources for patients across the reproductive age range. Future implementation studies may assist in aiding dissemination of these tools into clinical practice.
OBJECTIVE: Despite recommendations internationally for the timely provision of fertility information, cancerpatients report unmet information needs, with poor provision and inadequate written information to assist in fertility preservation decision-making. Patient decision aids (PtDAs) may be a useful resource in this setting to inform patients and guide decision-making. A systematic review of the literature on decision aids for fertility preservation in cancerpatients would determine the effectiveness of these tools in supporting decision-making about fertility preservation and indicate their current use in clinical care. METHODS: A systematic review was conducted in March 2018, within electronic search databases Medline, EMBASE, PSYCH Info, PubMed, and Web of Science. An initial search identified 718 potentially relevant articles from databases and screening of relevant reference lists. RESULTS: A total of 12 papers, detailing 11 studies with a total of 772 participants, evaluating nine decision aids, were included within the review. PtDAs were shown to significantly increase fertility preservation knowledge and decrease decisional conflict. Overall satisfaction with decision aids was high. Currently, only two reviewed decision aids are available for cancerpatients. Another tool has been integrated into a web page, and one implementation study has been completed. CONCLUSIONS: PtDAs can serve as effective complements to current fertility counselling practices by increasing information satisfaction and decision-making outcomes. More research is needed into the appropriateness of these resources for patients across the reproductive age range. Future implementation studies may assist in aiding dissemination of these tools into clinical practice.
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