Feasibility and effects of a decision aid about fertility preservation

Abstract

This paper reports on the feasibility and preliminary effects of a decision aid (DA) about female fertility preservation (FP). We conducted a pilot multicentre randomized controlled trial of women with breast cancer aged 18-40 who were randomized to brochures or the DA. Over 18 months, 62 women were eligible, of which 42 were invited by their healthcare provider (74%) to participate in the study. A total of 36 women signed up for participation and 26 (72%) were randomized to brochures (n ¼ 13) or the DA (n ¼ 13). In both groups, many women (87%) read the brochures and eight women used all available brochures. In the intervention group, 7/13 women logged in to the DA. Women who received brochures had slightly less decisional conflict, whereas knowledge improved in both groups. Our results indicate that both brochures about FP and a detailed DA have beneficial effects with regard to knowledge, but the DA seemed to introduce slightly more decisional conflict (DC) than the brochures. Although we encountered challenges with recruitment, our design and measurements seem feasible and the effects of the information materials seem promising, hence justifying conducting a larger study. ARTICLE HISTORY

Systematic review of fertility preservation patient decision aids for cancer patients

“…The studies were published between 2009 and 2018 and originated from six countries. One study utilised mixed‐methods design (questionnaires and interviews) while all others were quantitative, utilising online or paper‐based questionnaires . Study type was categorised according to an efficacy and effectiveness rating tool .…”

“…Study type was categorised according to an efficacy and effectiveness rating tool . One study was developmental, five contained both stages of development and efficacy, five were efficacy or effectiveness studies, and one was an implementation study …”

“…Patient populations differed on stage of treatment. Four studies specifically recruited newly diagnosed patients, or patients who had yet to commence any adjuvant therapies . One study recruited patients who had undergone no more than 1 week of treatment .…”

“…Five of the tools were in English, and there was one each in Portuguese, Dutch, German, and Japanese . The PtDAs typically consisted of informative sections and interactive sections with values clarification exercises, quizzes to assess patient knowledge, and space for notes or questions . Video testimonials from female cancer survivors who had made decisions about fertility preservation in the past were also included …”

“…One PtDA had separate sections developed for patients and clinicians . The majority of PtDAs were solely targeted at female cancer patients (n = 6) . Two tools were designed for male patients, one of which from a study that developed a separate PtDA for both male and female patients .…”