How well do healthcare professionals know of the priorities of their older patients regarding treatment outcomes?

Festen, Suzanne; Stegmann, Mariken; Prins, Annemiek; Munster, Barbara C. Van; Leeuwen, Barbara L. van; Halmos, György B.; Graeff, Pauline de; Brandenbarg, Daan

doi:10.1016/j.pec.2021.02.044

Cited by 16 publications

(15 citation statements)

References 25 publications

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“…In general, the representativeness of patients was good, although a few studies asked patients to provide answers for a hypothetical situation—for example, what they would choose if they had a different type or stage of cancer [ 29 , 40 ]. Some studies did not clearly report how specific outcomes were selected [ 28 , 29 ], or did not describe selection procedures at all [ 41 , 47 , 48 , 50 ]. Additionally, sometimes it was unclear how quality of life or other attributes were defined or were described to patients [ 27 , 39 ].…”

Section: Resultsmentioning

confidence: 99%

“…In a subgroup analysis of six studies focusing specifically on older patients [ 28 , 36 , 37 , 41 , 47 , 50 ] (median age of the study population of 70 years or higher or separate data of this subgroup), quality of life and overall survival were included in five of the six studies. They were also the highest or second-highest priority in most of them ( n = 5/6, 83%, and n = 4/6, 67%, respectively), followed by progression- and disease-free survival ( n = ½; 50%), severe and persistent side effects ( n = 1/3; 33%), treatment response ( n = 1/5; 20%), and transient short-term side effects ( n = 0/2; 0%; see Table 2 , Figure 4 ).…”

Section: Resultsmentioning

confidence: 99%

“…These unique patient values that underlie the preference are not easily incorporated into disease- and treatment-specific decision aids. Moreover, physicians are not good at estimating their patients’ preferences [ 50 ]. Thus it can be helpful to have an additional preference assessment conversation as part of decision-making.…”

Section: Discussionmentioning

confidence: 99%

“…In our review, some studies [ 41 , 50 ] used a non-disease and non-treatment-specific generic communication tool developed for patients with multimorbidity by Terri Fried: the Outcome Prioritization Tool (OPT) [ 15 ]. During this conversation, the healthcare professional verifies whether he or she understands the trade-offs correctly and invites the patient to explain why the outcomes are important and how they were interpreted [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…During this conversation, the healthcare professional verifies whether he or she understands the trade-offs correctly and invites the patient to explain why the outcomes are important and how they were interpreted [ 14 ]. Although this tool has been used in oncology patients before [ 41 , 50 , 64 ], it might be worthwhile to adapt this tool specifically for cancer patients and the treatment decisions they have to make.…”

Section: Discussionmentioning

confidence: 99%

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Patient Preferences for Treatment Outcomes in Oncology with a Focus on the Older Patient—A Systematic Review

Seghers

Wiersma

Festen

et al. 2022

Cancers

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For physicians, it is important to know which treatment outcomes are prioritized overall by older patients with cancer, since this will help them to tailor the amount of information and treatment recommendations. Older patients might prioritize other outcomes than younger patients. Our objective is to summarize which outcomes matter most to older patients with cancer. A systematic review was conducted, in which we searched Embase and Medline on 22 December 2020. Studies were eligible if they reported some form of prioritization of outcome categories relative to each other in patients with all types of cancer and if they included at least three outcome categories. Subsequently, for each study, the highest or second-highest outcome category was identified and presented in relation to the number of studies that included that outcome category. An adapted Newcastle–Ottawa Scale was used to assess the risk of bias. In total, 4374 patients were asked for their priorities in 28 studies that were included. Only six of these studies had a population with a median age above 70. Of all the studies, 79% identified quality of life as the highest or second-highest priority, followed by overall survival (67%), progression- and disease-free survival (56%), absence of severe or persistent treatment side effects (54%), and treatment response (50%). Absence of transient short-term side effects was prioritized in 16%. The studies were heterogeneous considering age, cancer type, and treatment settings. Overall, quality of life, overall survival, progression- and disease-free survival, and severe and persistent side effects of treatment are the outcomes that receive the highest priority on a group level when patients with cancer need to make trade-offs in oncologic treatment decisions.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Patient Preferences for Treatment Outcomes in Oncology with a Focus on the Older Patient—A Systematic Review

Seghers

Wiersma

Festen

et al. 2022

Cancers

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Outcome prioritization and preferences among older adults with cancer starting chemotherapy in a randomized clinical trial

Soto‐Perez‐de‐Celis,

Dale,

Katheria

et al. 2024

Cancer

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IntroductionOlder adults with cancer facing competing treatments must prioritize between various outcomes. This study assessed health outcome prioritization among older adults with cancer starting chemotherapy.MethodsSecondary analysis of a randomized trial addressing vulnerabilities in older adults with cancer. Patients completed three validated outcome prioritization tools: 1) Health Outcomes Tool: prioritizes outcomes (survival, independence, symptoms) using a visual analog scale; 2) Now vs. Later Tool: rates the importance of quality of life at three times—today versus 1 or 5 years in the future; and 3) Attitude Scale: rates agreement with outcome‐related statements. The authors measured the proportion of patients prioritizing various outcomes and evaluated their characteristics.ResultsA total of 219 patients (median [range] age 71 [65–88], 68% with metastatic disease) were included. On the Health Outcomes Tool, 60.7% prioritized survival over other outcomes. Having localized disease was associated with choosing survival as top priority. On the Now vs. Later Tool, 50% gave equal importance to current versus future quality of life. On the Attitude Scale, 53.4% disagreed with the statement “the most important thing to me is living as long as I can, no matter what my quality of life is”; and 82.2% agreed with the statement “it is more important to me to maintain my thinking ability than to live as long as possible”.ConclusionAlthough survival was the top priority for most participants, some older individuals with cancer prioritize other outcomes, such as cognition and function. Clinicians should elicit patient‐defined priorities and include them in decision‐making.

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INGETROKKEN HOOFDSTUK: De rol van de huisarts

Brandenbarg,

Lucassen

2024

Klachten Na Kanker

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How well do healthcare professionals know of the priorities of their older patients regarding treatment outcomes?

Cited by 16 publications

References 25 publications

Patient Preferences for Treatment Outcomes in Oncology with a Focus on the Older Patient—A Systematic Review

Patient Preferences for Treatment Outcomes in Oncology with a Focus on the Older Patient—A Systematic Review

Outcome prioritization and preferences among older adults with cancer starting chemotherapy in a randomized clinical trial

INGETROKKEN HOOFDSTUK: De rol van de huisarts

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