Considering patient values and treatment preferences enhances patient involvement in rectal cancer treatment decision making

• Published in: Radiotherapy and oncology Vol. 117; no. 2; pp. 338 - 342
• Main Authors: Kunneman, Marleen, Marijnen, Corrie A.M, Baas-Thijssen, Monique C.M, van der Linden, Yvette M, Rozema, Tom, Muller, Karin, Geijsen, Elisabeth D, Stiggelbout, Anne M, Pieterse, Arwen H
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01.11.2015
• Subjects: Adult; Aged; Aged, 80 and over; Clinical Decision-Making - methods; Communication; Female; Hematology, Oncology and Palliative Medicine; Humans; Male; Middle Aged; Netherlands; Patient Participation - methods; Patient Participation - statistics & numerical data; Patient values; Preoperative Care - methods; Preoperative radiotherapy; Rectal cancer; Rectal Neoplasms - radiotherapy; Rectal Neoplasms - surgery; Referral and Consultation - statistics & numerical data; Shared decision making; Surveys and Questionnaires; Treatment preferences; Netherlands; Preoperative radiotherapy; Treatment preferences; Shared decision making; Patient values; Rectal cancer; Communication
• ISSN: 0167-8140; 1879-0887
• DOI: 10.1016/j.radonc.2015.09.005

Abstract Background The shared decision making (SDM) model states that patients’ values and preferences should be clarified to choose a strategy that best fits the patient. This study aimed to assess whether values and preferences of rectal cancer patients are voiced and considered in deciding about preoperative radiotherapy (PRT), and whether this makes patients feel more involved in treatment decision making. Methods Pre-treatment consultations of radiation oncologists and patients eligible for PRT were audiotaped ( N = 90). Tapes were transcribed and coded to identify patients’ values and treatment preferences. Patients filled in a post-consultation questionnaire on their perceived involvement in decision making ( N = 60). Results Patients’ values were voiced for 62/611 of benefits/harms addressed (10%), in 38/90 consultations (42%; maximum 4 values per consultation), and most often related to major long-term treatment outcomes. Patients’ treatment preferences were discussed in 20/90 consultations (22%). In 16/90 consultations (18%), the oncologists explicitly indicated to consider patients’ values or preferences. Patients perceived a significantly more active role in decision making if their values or preferences had been voiced or considered. Conclusions Patients’ values and treatment preferences are voiced or considered in a minority of consultations. If they are, this increases patients’ perceived involvement in the decision making process.