Open AccessExpected survival with and without second‐line palliative chemotherapy: who wants to know?
Author(s) -
Oostendorp Linda J.M.,
Ottevanger Petronella B.,
Wouw Agnes J.,
Schoenaker Ivonne J.H.,
Graaf Hiltje,
Graaf Winette T.A.,
Stalmeier Peep F.M.
Publication year - 2015
Publication title -
health expectations
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.314
H-Index - 74
eISSN - 1369-7625
pISSN - 1369-6513
DOI - 10.1111/hex.12275
Subject(s) - psychosocial , medicine , palliative chemotherapy , exploratory research , family medicine , colorectal cancer , cancer , psychiatry , sociology , anthropology
Background According to surveys, many patients with advanced cancer wish to receive survival information. Objective This study investigated information preferences by offering patients a decision aid ( DA ) with information on expected survival for two treatment options: supportive care with or without second‐line palliative chemotherapy. Predictors of accepting survival information were explored. Design Eligible patients in this multicentre prospective study were offered second‐line chemotherapy for advanced breast or colorectal cancer. A nurse presented a DA on second‐line treatment and asked patients whether they desired information on (i) adverse events, (ii) tumour response and (iii) survival. Data on 50 clinical and psychosocial patient characteristics were collected from inclusion forms and patient questionnaires. Results Seventy‐seven patients received a DA ; median age 62 years (range 32–80), 61% female, 77% colorectal cancer. Fifty‐seven patients (74%; 95% CI 64–84) desired survival information. Four psychosocial characteristics (e.g. deliberative decision style) independently predicted information desire. However, the use of these characteristics to predict information desire hardly outperformed a simple prediction rule. Conclusions Many patients desired information on expected survival when deciding about second‐line treatment. However, our exploratory analysis indicated that patients desiring this information could not be identified based on their clinical or psychosocial characteristics. These findings can help encourage candid discussions about expected survival. Health professionals should be careful not to make implicit assumptions of information desire based on patient characteristics, but to explicitly ask patients if survival information is desired, and act accordingly.