Communication Between Physicians and Older Women With Localized Breast Cancer: Implications for Treatment and Patient Satisfaction

Liang, Wenchi; Burnett, Caroline B.; Rowland, Julia H.; Meropol, Neal J.; Eggert, Lynne; Hwang, Yi Ting; Silliman, Rebecca A.; Weeks, Jane C.; Mandelblatt, Jeanne S.

doi:10.1200/jco.20.4.1008

Cited by 128 publications

(91 citation statements)

References 36 publications

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“…1,[6][7][8][9][10][11][12][13][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] The patients' expectations also depend on the type of the disease, 15,20 or the type of the malignancy. 13,15,19,25 Most of the literature data on the attitude of breast cancer patients towards being informed, and participation in treatment decision come from Canada, 15,17,18,26,32 the US, 7,10,25,[27][28][29][30][31]34 Australia, 6,9,…”

Section: Discussionmentioning

confidence: 99%

“…In older patients, a better patientphysician communication associated with greater satisfaction with care was more often initiated by surgical oncologists and breast-specialists than by other surgeons. 30 We believe that psychooncological care, during all over the treatment process, is also of higher level in specialized breast units. 37 Among British breast cancer patients, those who were offered a choice of surgical treatment, showed less depression than those who were not.…”

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confidence: 99%

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Collaborative/active participationper se does not decrease anxiety in breast cancer

Kahán

Varga

Dudás

et al. 2006

Pathol. Oncol. Res.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Collaborative/active participationper se does not decrease anxiety in breast cancer

Kahán

Varga

Dudás

et al. 2006

Pathol. Oncol. Res.

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“…The same amount of information that is provided to younger patients with breast carcinoma by any given individual physician may be all that is required, which also was suggested in a study that indicated a correlation between the number of treatment options discussed and the receipt of BCS. 49 In addition, delivering age pertinent and/or ethnic group pertinent information on a personal basis, rather than relying on inanimate or other less private interpersonal sources of information, may further pave the way to optimizing the provision of information and reducing breast carcinoma treatment disparities in these vulnerable patient populations.…”

Section: Discussionmentioning

confidence: 99%

Health care disparities in older patients with breast carcinoma

Maly

Leake

Silliman

2003

Cancer

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BACKGROUNDLittle is known about how disparities in the treatment of patients with breast carcinoma based on patient age and ethnicity are effected or mitigated at the patient‐physician interaction level. The objectives of this study were to document physician provision of informational support to patients at the time of a new diagnosis of breast carcinoma and to assess differences according to patient age and ethnic group in terms of the information received and desired.METHODSParticipants were 222 patients with breast carcinoma in Los Angeles County, California, age ≥ 55 years who were interviewed within 6 months of their diagnosis of breast carcinoma and/or within 1 month posttreatment. Respondents were asked about receipt and helpfulness of 10 tangible informational support items (e.g., whether booklets, videotapes, medical records, etc. were provided by physicians) and 15 interactive informational support items (e.g., whether physicians discussed breast cancer topics, such as risk of recurrence or treatment options). An index of the tangible informational support items and a scale of the interactive informational support items received were created for summary analyses. Patients' medical records were abstracted for breast carcinoma stage and treatment type; surgeons also were surveyed about sociodemographic and practice characteristics.RESULTSIn multiple linear regression analyses, older age (β coefficient [β] ± standard error [SE], − 0.08 ± 0.02; P = 0.001) and Latina ethnicity (β ± SE, − 1.21 ± 0.40; P = 0.003) had a negative association with physician provision of interactive informational support, controlling for patient and physician sociodemographic characteristics, practice characteristics, breast carcinoma stage, comorbidity, number of physicians seen, visit length, social support, and patient self‐efficacy in interacting with physicians (adjusted correlation coefficient [R2] for the model, 0.33; P < 0.00001). Both older patients and ethnic minority patients, as well as their respective comparison groups, rated most breast cancer information as at least as helpful. Both groups preferred interpersonal sources of information to written sources, although they received interpersonal sources less frequently.CONCLUSIONSOlder patients and Latina patients with breast carcinoma received less interactive informational support from their physicians compared with younger patients, differences that persisted after controlling for a wide range of sociodemographic, psychosocial, and physician factors. Improving the quality of communication at the patient‐physician interaction level may be an important avenue to reducing age and ethnic group treatment disparities among patients with breast carcinoma. Cancer 2003;97:1517–27. © 2003 American Cancer Society.DOI 10.1002/cncr.11211

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“…44,45 In addition, outcome estimates are an important part of the initial discussion between a patient and physician regarding the relative benefit of various treatment options, and of the informed consent process. While it is possible that patients gave inflated estimates in a one-on-one interview setting or by telephone, as opposed to a more anonymous selfadministration setting, our results in this older, acutely ill population are consistent with previous studies that examined patients' estimates of the benefits of therapy and the deleterious effects that could occur from therapy.…”

Section: Discussionmentioning

confidence: 99%

Decision-making and quality of life in older adults with acute myeloid leukemia or advanced myelodysplastic syndrome

et al. 2004

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Older patients with acute myeloid leukemia (AML) and advanced myelodysplastic syndrome (aMDS) must decide between receiving intensive induction chemotherapy (IC) or nonintensive chemotherapy/best supportive care (NIC). Little information exists about what factors influence treatment decisions and what quality of life (QOL) is associated with treatment choices. We prospectively examined 43 patients 60 years or older who were interviewed at diagnosis and periodically over 1 year. IC choice was associated with younger age (66 vs 76 years, P ¼ 0.01) and AML diagnosis, but not with performance status, comorbidities, or QOL. In total, 63% of all patients reported not being offered other treatment options despite physician documentation of alternatives. Patient and physician estimates of cure differed significantly: 74% of patients estimated their chance of cure to be 50% or greater, yet for 89% of patients physician estimates of cure were 10% or less. IC patients experienced decreased QOL at 2 weeks, but rebounded to baseline and to NIC levels by 6 weeks. Initial QOL is not associated with treatment choice in older AML and aMDS patients. Regardless of treatment choice, patients report not being offered treatment options and overestimate their chances of cure. In IC patients, QOL decreases during hospitalization but rebounds after discharge.

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Communication Between Physicians and Older Women With Localized Breast Cancer: Implications for Treatment and Patient Satisfaction

Cited by 128 publications

References 36 publications

Collaborative/active participationper se does not decrease anxiety in breast cancer

Collaborative/active participationper se does not decrease anxiety in breast cancer

Health care disparities in older patients with breast carcinoma

Decision-making and quality of life in older adults with acute myeloid leukemia or advanced myelodysplastic syndrome

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