Oncologist, Patient and Companion Questions during Pre-Treatment Consultations About Adjuvant Cancer Treatment: A Shared Decision-Making Perspective

Abstract

Objectives

To assess the occurrence of questions that foster shared decision-making, in particular cancer patients' understanding of treatment decisions and oncologists' understanding of patients' priorities, during consultations in which preference-sensitive decisions are discussed. Specifically, regarding a) patient understanding, do oncologists ask about patients' pre-existing knowledge, information preferences, and understanding; do patients and companions ask about the disease and treatment; b) patient priorities, do oncologists ask about patients' treatment- and decision-related preferences; do patients and companions ask about the decision.

Methods

Audiotaped pre-treatment consultations of 100 cancer patients with 32 oncologists about (neo-)adjuvant treatment were coded and analysed to document question type, topic, and initiative.

Results

The oncologists ascertained prior knowledge in 50 patients, asked 24 about preferred (probability) information, and invited questions from 56 patients. The oncologists asked 32 patients about treatment preferences and/or for consent. Respectively one-third and one-fifth of patients and companions asked about treatment benefits compared to three-quarter of them who asked about treatment harms and/or procedures.

Conclusions

It would be helpful to patients if oncologists more often assessed patients' existing knowledge to tailor their information provision. Also, patients could receive treatment recommendations that better fit their personal situation if oncologists collected information on patients' views about treatments. Moreover, by educating patients to ask about treatment alternatives, benefits and harms, patients may gain a better understanding of the choice they have. This article is protected by copyright. All rights reserved.

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