Shared decision-making and patient decision aids in choosing first-line targeted therapy for metastatic colorectal cancer in Taiwan

Abstract

Introduction In Taiwan, given the discrepancy between current treatment guidelines and reimbursement options, patients might require a tool to support their decision-making process when selecting a regimen for metastatic colorectal cancer, especially therapeutic strategies, and subsequent costs, along with efficacy and safety outcomes. Therefore, we developed a patient decision aid (PDA) to support patients in choosing between treatment options recommended based on the current evidence and those reimbursed by the Taiwanese National Health Insurance. Methods By carefully reviewing the updated data and then interpreting the clinical tool, we conducted a needs assessment using a serial questionnaire to test for a step-by-step adjustment of the PDA. Results Patients, their relatives, and medical team members were most concerned about outcomes, such as overall survival, progression-free survival, objective response rate, tumor shrinkage to resectable status, total medical cost, severe gastrointestinal perforation, and severe skin reaction. After a serial alpha test for quality, we performed quantitative evaluation and beta tests, revealing average scores of more than 4 points (on a scale of 1–5) for both perceptibility and utility. Conclusions The present findings suggest that PDAs are useful and supplement the shared decision-making practice, helping patients make decisions about preferences and consider the pros and cons of treatment regimens, along with insurance reimbursement options.

Multimedia Mixed Reality Interactive Shared Decision-Making Game in Children with Moderate to Severe Atopic Dermatitis, a Pilot Study

“…In adults, the design of SDM auxiliary tools includes designing SDM first and not designing SDM first. At present, there is no head-to-head comparative analysis of designing SDM first or not [ 52 , 53 ]. In the paragraphs on the methods and results, we can see that the design of SDM and the design of the game each have their own protocols that need to be followed [ 32 , 45 ].…”

“…Ten-item SUS out of a maximum of 100 has been applied in many device systems including MR to evaluate usability [ 48 , 54 ]. Internet technological progress has changed the medical field, particularly with regard to SDM and pediatrics [ 33 , 42 , 52 , 53 ].…”

Preference Elicitation and Treatment Decision-Making Among Men Diagnosed With Prostate Cancer: Randomized Controlled Trial Results of Healium

“…The use of personal, technology-based decision aids empowers patients to identify and verbalize their own preferences and bring their concerns to the clinical consultation, which encourages an SDM process. Multiple studies demonstrate that the use of personal decision aids facilitates SDM [7][8][9]. To improve disease knowledge and facilitate SDM, our research group has developed several interactive, Internet-based decision aids for patients with prostate cancer [10][11][12] and those with breast cancer.…”