Clinician and cancer patient views on patient participation in treatment decision-making: a quantitative and qualitative exploration.

Publisher: Nature Publishing Group on behalf of Cancer Research UK Country of Publication: England NLM ID: 0370635 Publication Model: Print Cited Medium: Print ISSN: 0007-0920 (Print) Linking ISSN: 00070920 NLM ISO Abbreviation: Br J Cancer Subsets: MEDLINE

Publication: 2002- : London : Nature Publishing Group on behalf of Cancer Research UK
Original Publication: London, Lewis.

Decision Making* ; Disease Management* ; Medical Oncology* ; Patient Participation* ; Physician-Patient Relations*; Neoplasms/*therapy; Adult ; Aged ; Aged, 80 and over ; Attitude of Health Personnel ; Attitude to Health ; Female ; Humans ; Male ; Middle Aged ; Multicenter Studies as Topic ; Patient Satisfaction

Patient participation in treatment decision-making is being increasingly advocated, although cancer treatments are often guideline-driven. Trade-offs between benefits and side effects underlying guidelines are made by clinicians. Evidence suggests that clinicians are inaccurate at predicting patient values. The aim was to assess what role oncologists and cancer patients prefer in deciding about treatment, and how they view patient participation in treatment decision-making. Seventy disease-free cancer patients and 60 oncologists (surgical, radiation, and medical) were interviewed about their role preferences using the Control Preferences Scale (CPS) and about their views on patient participation using closed- and open-ended questions. Almost all participants preferred treatment decisions to be the outcome of a shared process. Clinicians viewed participation more often as reaching an agreement, whereas 23% of patients defined participation exclusively as being informed. Of the participants, > or = 81% thought not all patients are able to participate and > or = 74% thought clinicians are not always able to weigh the pros and cons of treatment for patients, especially not quality as compared with length of life. Clinicians seemed reluctant to share probability information on the likely impact of adjuvant treatment. Clinicians should acknowledge the legitimacy of patients' values in treatment decisions. Guidelines should recommend elicitation of patient values at specific decision points.

Patient Educ Couns. 2006 Mar;60(3):301-12. (PMID: 16051459)
Breast Cancer Res Treat. 2003 May;79(2):225-31. (PMID: 12825857)
Med Decis Making. 2007 Sep-Oct;27(5):539-46. (PMID: 17873252)
J Clin Epidemiol. 1992 Sep;45(9):941-50. (PMID: 1432023)
Br J Cancer. 2007 Sep 17;97(6):717-24. (PMID: 17848910)
J Gen Intern Med. 1989 Jan-Feb;4(1):23-30. (PMID: 2644407)
Soc Sci Med. 2007 Oct;65(7):1442-57. (PMID: 17614177)
Health Expect. 1999 Dec;2(4):266-276. (PMID: 11281903)
Patient Educ Couns. 2007 Nov;68(3):243-51. (PMID: 17904327)
Can J Nurs Res. 1997 Fall;29(3):21-43. (PMID: 9505581)
Eur J Oncol Nurs. 2008 Sep;12(4):299-318. (PMID: 18486552)
Soc Sci Med. 1998 Aug;47(3):329-39. (PMID: 9681902)
Fam Med. 2002 May;34(5):383-9. (PMID: 12038721)
Soc Sci Med. 1999 Sep;49(5):651-61. (PMID: 10452420)
Injury. 2006 Apr;37(4):328-34. (PMID: 16480987)
Sci Am. 2004 Apr;290(4):70-5. (PMID: 15045756)
J Clin Oncol. 2003 Mar 1;21(5):932-6. (PMID: 12610196)
Am J Gastroenterol. 2001 Sep;96(9):2730-6. (PMID: 11569703)
J Surg Res. 2004 Aug;120(2):278-87. (PMID: 15234224)
J Gen Intern Med. 2007 May;22(5):614-9. (PMID: 17443368)
J Clin Oncol. 1998 Feb;16(2):515-21. (PMID: 9469335)
Behav Med. 1998 Summer;24(2):81-8. (PMID: 9695899)
Health Expect. 2005 Jun;8(2):103-13. (PMID: 15860051)
Acta Oncol. 2000;39(4):467-76. (PMID: 11041108)
Br J Cancer. 2001 Nov 2;85(9):1273-9. (PMID: 11720460)
Qual Health Care. 2001 Sep;10 Suppl 1:i34-8. (PMID: 11533436)
Soc Sci Med. 1988;27(11):1139-45. (PMID: 3206248)
Br J Cancer. 1995 Feb;71(2):388-92. (PMID: 7841058)
J Clin Oncol. 2007 Jul 20;25(21):3096-100. (PMID: 17634489)
Med Care. 2005 Oct;43(10):960-9. (PMID: 16166865)
Oncol Nurs Forum. 1995 Oct;22(9):1401-8. (PMID: 8539181)
BMJ. 1999 Sep 18;319(7212):780-2. (PMID: 10488014)
Patient Educ Couns. 2006 Sep;62(3):291-8. (PMID: 16859860)
Qual Health Care. 2001 Sep;10 Suppl 1:i39-43. (PMID: 11533437)
JAMA. 1997 May 14;277(18):1485-92. (PMID: 9145723)
JAMA. 1995 Apr 19;273(15):1219-20. (PMID: 7707631)
N Engl J Med. 2001 Aug 30;345(9):638-46. (PMID: 11547717)
Health Psychol. 2003 May;22(3):235-44. (PMID: 12790250)
Psychooncology. 2006 Apr;15(4):297-305. (PMID: 16041829)
J Gen Intern Med. 1995 Nov;10(11):593-600. (PMID: 8583261)
J Support Oncol. 2007 Jan;5(1):36-40, 46. (PMID: 17265785)
Am J Bioeth. 2007 Jul;7(7):33-8. (PMID: 17654382)
Eur J Cancer. 1997 Jul;33(8):1184-9. (PMID: 9301440)
Soc Sci Med. 2004 May;58(9):1699-707. (PMID: 14990371)

Date Created: 20080911 Date Completed: 20090312 Latest Revision: 20211020

20250114

PMC2538766

10.1038/sj.bjc.6604611

18781148