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Importance of quality‐of‐life priorities and preferences surrounding treatment decision making in patients with cancer and oncology clinicians
Author(s) -
Williams Courtney P.,
MillerSonet Ellen,
Nipp Ryan D.,
Kamal Arif H.,
Love Susan,
Rocque Gabrielle B.
Publication year - 2020
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.32961
Subject(s) - medicine , quality of life (healthcare) , documentation , family medicine , quality (philosophy) , medline , breast cancer , oncology , cancer , nursing , philosophy , epistemology , computer science , political science , law , programming language
Background Shared decision‐making (SDM) occurs when a patient partners with their oncologist to integrate personal preferences and values into treatment decisions. A key component of SDM is the elicitation of patient preferences and values, yet little is known about how and when these are elicited, communicated, prioritized, and documented within clinical encounters. Methods This cross‐sectional study evaluated nationwide data collected by Cancer Care to better understand current patterns of SDM between patients and their oncology clinicians. Patient surveys included questions about the importance of quality‐of‐life preferences and discussions regarding quality‐of‐life priorities with their clinicians. Clinician surveys included questions about the discussion of quality‐of‐life priorities and preferences with patients, the effect of quality‐of‐life priorities on treatment recommendations, and quality‐of‐life priority documentation in practice. Results Patient survey completers (n = 320; 33% response rate) were predominantly women (95%), had a diagnosis of breast cancer (59%), or were receiving active cancer treatment (59%). Clinician survey completers (n = 112; 5% response rate) predominately identified as hematologists or oncologists (66%). Although 67% of clinicians reported knowing their patients' personal quality‐of‐life priorities and preferences before finalizing treatment plans, only 37% of patients reported that these discussions occurred before treatment initiation. Most patients (95%) considered out‐of‐pocket expenses important during treatment planning, yet only 59% reported discussing out‐of‐pocket expenses with their clinician before finalizing treatment plans. A majority of clinicians (52%) considered clinic questionnaires as feasible to document quality‐of‐life priorities and preferences. Conclusions Patients and clinicians reported that preferences related to quality‐of‐life should be considered in treatment decision making, yet barriers to SDM, preference elicitation, and documentation remain.