What do patients and health care professionals view as important attributes in radiotherapy decisions? Input for a breast cancer patient decision aid

Objectives: The aim of this study was to develop a breast cancer Patient Decision Aid (PDA), using a Health Technology Assessment (HTA) process, to assist patients in their choice of therapeutic options, and to promote shared decision making among patients, healthcare professionals, and other interested parties.Methods: A systematic review (SR) was conducted of existing breast cancer patient Decision Aids encountered in the main scientific journal databases and on institutional Web sites that create PDAs, together with a Qualitative Research (QR) study, using semi-structured interviews and focus group with stakeholders (patients, family members, and health professionals), with the aim of developing a PDA for breast cancer.Results: The SR shows that PDAs in breast cancer not only increase patient knowledge of the illness, leading to more realistic expectations of treatment outcomes, but also reduce passivity in the decision-making process and facilitate the appropriate choice of treatment options in accordance with patient medical and personal preferences. The analysis of QR shows that both breast cancer patients and healthcare professionals agree that surgery, adjuvant treatments, and breast reconstruction represent the most important decisions to be made. Worry, anxiety, optimism, and trust in healthcare professionals were determined as factors that most affected patients subjective experiences of the illness. This HTA was used as the basis for developing a PDA software program.Conclusions: The SR and QR used in the development of this PDA for breast cancer allowed patients to access information, gain additional knowledge of their illness, make shared treatment decisions, and gave healthcare professionals a deeper insight into patient experiences of the disease.

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Implementing a breast cancer patient decision aid: Process evaluation using medical files and the patients’ perspective

European Journal of Cancer Care ◽

10.1111/ecc.13387 ◽

2020 ◽

Author(s):

Wilma Savelberg ◽

Liesbeth J. Boersma ◽

Marjolein Smidt ◽

Trudy Weijden

Keyword(s):

Breast Cancer ◽

Cancer Patient ◽

Breast Cancer Patient ◽

Process Evaluation ◽

Decision Aid ◽

Patient Decision Aid ◽

Patient Decision ◽

Patients Perspective

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Patient decision aid for contralateral prophylactic mastectomy for use in the consultation: a feasibility study

Current Oncology ◽

10.3747/co.26.4689 ◽

2019 ◽

Vol 26 (2) ◽

Author(s):

J. E. Squires ◽

D. Stacey ◽

M. Coughlin ◽

M. Greenough ◽

A. Roberts ◽

...

Keyword(s):

Health Care ◽

Knowledge Translation ◽

Health Care Professionals ◽

Decision Aid ◽

Prophylactic Mastectomy ◽

Contralateral Prophylactic Mastectomy ◽

Shared Decision ◽

Patient Decision Aid ◽

Unilateral Breast Cancer ◽

Patient Decision

Background Rates of contralateral prophylactic mastectomy (cpm) continue to rise internationally despite evidence-based guidance strongly discouraging its use in most women with unilateral breast cancer. The purpose of the present study was to develop and assess the feasibility of a knowledge translation tool [a patient decision aid (da)] designed to enhance evidence-informed shared decision-making about cpm.Methods A consultation da was developed using the Ottawa Patient Decision Aid Development eTraining in consultation with clinicians and knowledge translation experts. The final da was then assessed for feasibility with health care professionals and patients across Canada. The assessment involved a survey completed online (health care professionals) or by telephone (patients). Survey data were analyzed using descriptive statistics for closed-ended questions and qualitative content analysis for open-ended questions.Results The 51 participants who completed the survey included 39 health care professionals and 12 patients. The da was acceptable; 88% of participants viewed it as having the right amount of information or slightly more or less information than they would like. Almost all participants (98%) felt that the da would prepare patients to make better decisions. The aid was perceived to be usable, with 73% of participants stating that they would be willing to use or share the da.Conclusions The cpm patient da developed for the present study was viewed by health care professionals and patients across Canada to be acceptable and usable during the clinical consultation. It holds promise as a knowledge translation tool to be used by clinicians in consultation with women who have unilateral breast cancer to enhance evidence-informed and shared decision-making with respect to undergoing cpm.

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