Open AccessAwareness of and Preference for Disease Prognosis and Participation in Treatment Decisions Among Patients With Advanced Cancer in Myanmar: Results From the APPROACH study
Author(s) -
S. Mon,
Wah Wah Myint Zu,
Myo Maw,
Han Win,
Kyaw Zin Thant,
Grace Meijuan Yang,
Chetna Malhotra,
Irene Teo,
Eric A. Finkelstein,
Semra Özdemir
Publication year - 2020
Publication title -
jco global oncology
Language(s) - English
Resource type - Journals
ISSN - 2687-8941
DOI - 10.1200/go.20.50000
Subject(s) - medicine , preference , disease , descriptive statistics , cancer , family medicine , stage (stratigraphy) , paleontology , statistics , mathematics , economics , biology , microeconomics
PURPOSE The aim of this study was to investigate prognostic awareness, preference for prognostic information, and perceived and preferred roles in decision making among patients with advanced cancer in Myanmar.METHODS A cross-sectional survey was administered at Yangon General Hospital to patients with stage 4 cancer who were at least 21 years old and aware of their cancer diagnosis. Patients were asked questions about their prognosis, treatment decisions, and sociodemographic and clinical information. Data from 131 patients were analyzed using descriptive and comparative statistics.RESULTS Only 15% of patients surveyed were aware that their cancer was advanced, and only 26% knew that it was terminal. One third of patients (34%) had prognostic awareness, defined as the knowledge that treatment intent is noncurative. The likelihood of awareness was higher among patients who were male, high income, and aware that they had advanced cancer. Approximately 60% of patients reported playing an active or collaborative role in treatment decisions, with a strong preference (59%) for the latter. For the majority of patients (69%), perceived and preferred roles in decision making were the same. Sociodemographic characteristics did not predict perceived and preferred roles in decision making.CONCLUSION To our knowledge, this is the first effort to analyze prognostic awareness and decision-making practices among patients with advanced stage cancer in Myanmar. Patients had inadequate knowledge of their disease progression and intent of treatment. Yet, a majority of them were keen to be involved in treatment decisions. Thus, physicians should effectively communicate prognosis and treatment intent, encouraging patients to participate in decisions whenever possible.