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Effects of a time out consultation with the general practitioner on cancer treatment decision‐making: a randomised controlled trial
Author(s) -
Perfors Ietje A.A.,
Noteboom Eveline A.,
de Wit Niek J.,
van der Wall Elsken,
Visserman Ella A.,
van Dalen Thijs,
Verhagen Marc A.M.T.,
Witkamp Arjen J.,
Koelemij Ron,
Flinterman Annebeth E.,
van Dorst Eleonora B.L.,
PruissenPeeters Kim A.B.M.,
Moons Leon M.G.,
Schramel Franz M.N.H.,
van Rens Marcel T.M.,
Ernst Miranda F.,
May Anne M.,
Helsper Charles W.
Publication year - 2021
Publication title -
psycho‐oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.41
H-Index - 137
eISSN - 1099-1611
pISSN - 1057-9249
DOI - 10.1002/pon.5604
Subject(s) - medicine , intervention (counseling) , randomized controlled trial , cancer , breast cancer , primary care , family medicine , nursing
Objective Improving shared decision‐making (SDM) enables more tailored cancer treatment decisions. We evaluated a Time Out consultation (TOC) with the general practitioner (GP), between cancer diagnosis and treatment decision, which aims at supporting SDM and improving continuity of primary care. This study aims to evaluate the effects of a TOC on perceived SDM, information provision and self‐efficacy. Methods This randomised controlled trial included newly diagnosed patients with curable cancer (breast, lung, colorectal, gynaecologic and melanoma) from four Dutch hospitals. Primary outcome is perceived SDM and secondary outcomes are information provision and self‐efficacy. Results One hundred fifty‐four patients (control n = 77, intervention n = 77) – female: 75%, mean age: 61 (SD ± 11.9). In the intervention group, 80.5% ( n = 62) had a TOC, of which 82.3% ( n = 51) took place after treatment decision. Perceived SDM was lower in the intervention group (−8.9 [95% CI: 0.6–17.1]). Among those with a TOC before treatment decision ( n = 11), perceived SDM was comparable to the control group (66.5 ± 27.2 vs. 67.9 ± 26.1). Conclusion Even though patients are motivated to have a TOC, implementing a TOC between diagnosis and treatment decision is challenging. Effects of a timely TOC could not be established. Non‐timely TOC decreased perceived SDM. Planning of the TOC should be optimised, and future research should establish if adequately timed TOC results in improved SDM in cancer patients.