Erin B Moth1, Belinda E Kiely2, Andrew Martin3, Vasi Naganathan4, Stephen Della-Fiorentina5, Florian Honeyball6, Rob Zielinski7, Christopher Steer8, Hiren Mandaliya9, Abiramy Ragunathan9, Prunella Blinman10. 1. Concord Cancer Centre, Concord Repatriation General Hospital, Concord, NSW, Australia; Concord Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia. Electronic address: erin.moth@health.nsw.gov.au. 2. Concord Cancer Centre, Concord Repatriation General Hospital, Concord, NSW, Australia; Macarthur Cancer Therapy Centre, Campbelltown Hospital, Campbelltown, NSW, Australia; National Health and Medical Research Council, University of Sydney, Sydney, NSW, Australia. 3. National Health and Medical Research Council, University of Sydney, Sydney, NSW, Australia. 4. Concord Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; Centre for Education and Research on Ageing, Concord Repatriation General Hospital, University of Sydney, Sydney, NSW, Australia; Ageing and Alzheimer's Institute, Concord Repatriation General Hospital, Sydney, NSW, Australia. 5. Macarthur Cancer Therapy Centre, Campbelltown Hospital, Campbelltown, NSW, Australia; Southern Highlands Cancer Centre, Bowral, NSW, Australia. 6. Alan Coates Cancer Centre, Dubbo Base Hospital, Dubbo, NSW, Australia. 7. Central West Cancer Care Centre, Orange Base Hospital, Orange, NSW, Australia. 8. Border Medical Oncology, Albury Wodonga Regional Cancer Centre, Albury, NSW, Australia. 9. Macarthur Cancer Therapy Centre, Campbelltown Hospital, Campbelltown, NSW, Australia. 10. Concord Cancer Centre, Concord Repatriation General Hospital, Concord, NSW, Australia; Concord Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
Abstract
AIM: Patients with cancer have varied preferences for involvement in decision-making. We sought older adults' preferred and perceived roles in decision-making about palliative chemotherapy; priorities; and information received and desired. METHODS: Patients ≥65y who had made a decision about palliative chemotherapy with an oncologist completed a written questionnaire. Preferred and perceived decision-making roles were assessed by the Control Preferences Scale. Wilcoxon rank-sum tests evaluated associations with preferred role. Factors important in decision-making were rated and ranked, and receipt of, and desire for information was described. RESULTS: Characteristics of the 179 respondents: median age 74y, male (64%), having chemotherapy (83%), vulnerable (Vulnerable Elders Survey-13 score ≥ 3) (52%). Preferred decision-making roles (n = 173) were active in 39%, collaborative in 27%, and passive in 35%. Perceived decision-making roles (n = 172) were active in 42%, collaborative in 22%, and passive in 36% and matched the preferred role for 63% of patients. Associated with preference for an active role: being single/widowed (p = .004, OR = 1.49), having declined chemotherapy (p = .02, OR = 2.00). Ranked most important (n = 159) were "doing everything possible" (30%), "my doctor's recommendation" (26%), "my quality of life" (20%), and "living longer" (15%). A minority expected chemotherapy to cure their cancer (14%). Most had discussed expectations of cure (70%), side effects (88%) and benefits (82%) of chemotherapy. Fewer had received quantitative prognostic information (49%) than desired this information (67%). CONCLUSION: Older adults exhibited a range of preferences for involvement in decision-making about palliative chemotherapy. Oncologists should seek patients' decision-making preferences, priorities, and information needs when discussing palliative chemotherapy.
AIM: Patients with cancer have varied preferences for involvement in decision-making. We sought older adults' preferred and perceived roles in decision-making about palliative chemotherapy; priorities; and information received and desired. METHODS:Patients ≥65y who had made a decision about palliative chemotherapy with an oncologist completed a written questionnaire. Preferred and perceived decision-making roles were assessed by the Control Preferences Scale. Wilcoxon rank-sum tests evaluated associations with preferred role. Factors important in decision-making were rated and ranked, and receipt of, and desire for information was described. RESULTS: Characteristics of the 179 respondents: median age 74y, male (64%), having chemotherapy (83%), vulnerable (Vulnerable Elders Survey-13 score ≥ 3) (52%). Preferred decision-making roles (n = 173) were active in 39%, collaborative in 27%, and passive in 35%. Perceived decision-making roles (n = 172) were active in 42%, collaborative in 22%, and passive in 36% and matched the preferred role for 63% of patients. Associated with preference for an active role: being single/widowed (p = .004, OR = 1.49), having declined chemotherapy (p = .02, OR = 2.00). Ranked most important (n = 159) were "doing everything possible" (30%), "my doctor's recommendation" (26%), "my quality of life" (20%), and "living longer" (15%). A minority expected chemotherapy to cure their cancer (14%). Most had discussed expectations of cure (70%), side effects (88%) and benefits (82%) of chemotherapy. Fewer had received quantitative prognostic information (49%) than desired this information (67%). CONCLUSION: Older adults exhibited a range of preferences for involvement in decision-making about palliative chemotherapy. Oncologists should seek patients' decision-making preferences, priorities, and information needs when discussing palliative chemotherapy.
Authors: Kah Poh Loh; Mazie Tsang; Thomas W LeBlanc; Anthony Back; Paul R Duberstein; Supriya Gupta Mohile; Ronald M Epstein; Heidi D Klepin; Michael W Becker; Areej El-Jawahri; Stephanie J Lee Journal: Blood Adv Date: 2020-11-10
Authors: Darryl Outlaw; Maya Abdallah; Luiz A Gil-Jr; Smith Giri; Tina Hsu; Jessica L Krok-Schoen; Gabor Liposits; Tânia Madureira; Joana Marinho; Ishwaria M Subbiah; Gina Tuch; Grant R Williams Journal: Semin Radiat Oncol Date: 2022-04 Impact factor: 5.934