TY - JOUR
T1 - Shared decision making in recurrent ovarian cancer: Implementation of patient decision aids across three departments of oncology in Denmark
AU - Wulff, Christian Nielsen
AU - Hæe, Mette
AU - Hansen, Dorte Gilså
AU - Olling, Karina
AU - Jensen, Karina Mølgaard
AU - Knudsen, Anja Ør
AU - Fokdal, Lars
AU - Steffensen, Karina Dahl
PY - 2022/12
Y1 - 2022/12
N2 - Objective Patients with relapsed ovarian cancer are offered multiple treatment options. To match treatment with the individual patient's life situation and preferences, healthcare professionals can apply shared decision making (SDM) including patient decision aids (PtDAs). This study aimed to evaluate the implementation of two different PtDAs in consultations with patients suffering from relapsed ovarian cancer. Methods We analyzed the following data before and after implementation of the PtDAs: 1) observed SDM using the OPTION instrument, 2) physician treatment recommendations, and 3) patients' and physicians' evaluations of SDM in consultations using the CollaboRATE, SDM-Q-9, and SDM-Q-Doc. Results Significant improvement in observed SDM was found after the implementation (p = 0.002). Improvement of SDM was detected in consultations conducted by physicians reporting more than two hours of SDM-training (p < 0.001), but not when physicians reported less than two hours of SDM-training. No before/after differences in treatment recommendations and in patients' and physicians' evaluations were found. Conclusion Implementation of PtDAs improved the level of observed SDM. Training of physicians in SDM is necessary for improved SDM practice. Innovation Discussing oncological treatment options with the use of PtDAs is not standard practice in Denmark. The present study is one of the first Danish studies focusing on how to implement SDM and PtDAs in oncological consultations.
AB - Objective Patients with relapsed ovarian cancer are offered multiple treatment options. To match treatment with the individual patient's life situation and preferences, healthcare professionals can apply shared decision making (SDM) including patient decision aids (PtDAs). This study aimed to evaluate the implementation of two different PtDAs in consultations with patients suffering from relapsed ovarian cancer. Methods We analyzed the following data before and after implementation of the PtDAs: 1) observed SDM using the OPTION instrument, 2) physician treatment recommendations, and 3) patients' and physicians' evaluations of SDM in consultations using the CollaboRATE, SDM-Q-9, and SDM-Q-Doc. Results Significant improvement in observed SDM was found after the implementation (p = 0.002). Improvement of SDM was detected in consultations conducted by physicians reporting more than two hours of SDM-training (p < 0.001), but not when physicians reported less than two hours of SDM-training. No before/after differences in treatment recommendations and in patients' and physicians' evaluations were found. Conclusion Implementation of PtDAs improved the level of observed SDM. Training of physicians in SDM is necessary for improved SDM practice. Innovation Discussing oncological treatment options with the use of PtDAs is not standard practice in Denmark. The present study is one of the first Danish studies focusing on how to implement SDM and PtDAs in oncological consultations.
KW - Cancer
KW - Patient decision aids
KW - Patient-provider communication
KW - Shared decision making
U2 - 10.1016/j.pecinn.2022.100095
DO - 10.1016/j.pecinn.2022.100095
M3 - Journal article
C2 - 37213765
SN - 2772-6282
VL - 1
JO - PEC Innovation
JF - PEC Innovation
M1 - 100095
ER -