The Perception of Shared Decision‐Making in Hematology by Patients and Physicians Seems Satisfactory, but Important Steps are Still Ahead of Us

Geerts, P; Moser, Albine; Bos, Gerard M.J.

doi:10.1097/hs9.0000000000000417

Cited by 9 publications

(5 citation statements)

References 16 publications

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“…While we do not have a comparison arm, previous studies exploring SDM for treatment decisions have reported a range of 11–100, with a median score of 84 in a study of patients with hematologic malignancies. 49 Mean scores on PCC‐Ca (a measure of patient‐centered communication) were 4.4 and 4.1 (out of five) for patients and caregivers, respectively, at post‐intervention. In a cross‐sectional study of patients with ovarian cancer, the mean score on PCC‐Ca was 4.09.…”

Section: Discussionmentioning

confidence: 97%

“…At post‐intervention, patients reported a mean score of 89.4 (SD 14.4) on SDM‐Q‐9 (a measure of SDM). While we do not have a comparison arm, previous studies exploring SDM for treatment decisions have reported a range of 11–100, with a median score of 84 in a study of patients with hematologic malignancies 49 . Mean scores on PCC‐Ca (a measure of patient‐centered communication) were 4.4 and 4.1 (out of five) for patients and caregivers, respectively, at post‐intervention.…”

Section: Discussionmentioning

confidence: 99%

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Patient‐centered communication tool for older patients with acute myeloid leukemia, their caregivers, and oncologists: A single‐arm pilot study

LoCastro

Sanapala²,

Wang

et al. 2022

Cancer Medicine

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Background In a single‐arm pilot study, we assessed the feasibility and usefulness of an innovative patient‐centered communication tool (UR‐GOAL tool) that addresses aging‐related vulnerabilities, patient values, and prognostic awareness for use in treatment decision making between older adults with newly diagnosed acute myeloid leukemia (AML), their caregivers, and oncologists. Methods Primary feasibility metric was retention rate; >50% was considered feasible. We collected recruitment rate, usefulness, and outcomes including AML knowledge (range 0–14) and perceived efficacy in communicating with oncologists (range 5–25). Due to the pilot nature and small sample size, hypothesis testing was performed at α = 0.10. Results We included 15 patients (mean age 76 years, range 64–88), 12 caregivers, and 5 oncologists; enrollment and retention rates for patients were 84% and 73%, respectively. Patients agreed that the UR‐GOAL tool helped them understand their AML diagnosis and treatment options, communicate with their oncologist, and make more informed decisions. From baseline to post‐intervention, patients and caregivers scored numerically higher on AML knowledge (patients: +0.6, p = 0.22; caregivers: +1.1, p = 0.05) and perceived greater efficacy in communicating with their oncologists (patients: +1.5, p = 0.22; caregivers: +1.2, p = 0.06). Conclusion We demonstrated that it is feasible to incorporate the UR‐GOAL tool into treatment decision making for older patients with AML, their caregivers, and oncologists.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Patient‐centered communication tool for older patients with acute myeloid leukemia, their caregivers, and oncologists: A single‐arm pilot study

LoCastro

Sanapala²,

Wang

et al. 2022

Cancer Medicine

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“…(30) Decision-making strategies Physician-directed I think we should definitely aim for cure in your case, and the only cure for myelodysplastic syndrome is a bone marrow transplant. (22) Patient-driven I think then you may just have to do a little more thinking on your end about whether this is, this is what you want to do. (18) My hope is to give you information and to help you minimize risks, to do what you want to do.…”

Section: Discussionmentioning

confidence: 99%

“…[15][16][17] Ultimately, patients must decide whether to pursue alloHCT versus an alternative pathway that may prolong their life and/or help with symptoms but offer no chance for cure. [18][19][20] Despite reported limitations of hematologists' communication, [21][22][23][24][25] we do not know how they discuss alloHCT and engage patients in decision making.…”

Section: Introductionmentioning

confidence: 99%

Communication Strategies of Transplant Hematologists in High-Risk Decision-Making Conversations

Rodenbach,

Thordardottir,

Brauer

et al. 2024

JCO Oncol Pract

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PURPOSE Shared decision making (SDM) is essential to empower patients with blood cancers to make goal-concordant decisions about allogeneic hematopoietic cell transplantation. This study characterizes communication strategies used by hematologists to discuss treatment options and facilitate SDM with patients in this high-risk, high-reward setting. METHODS AND MATERIALS We recruited US hematologists who routinely perform allogeneic hematopoietic cell transplant through email. Participants conducted up to an hour-long video-recorded encounter with an actor portraying a 67-year-old man with recently diagnosed high-risk myelodysplastic syndrome. We transcribed and qualitatively analyzed video-recorded data. RESULTS The mean age of participants (N = 37) was 44 years, 65% male, and 68% White. Many hematologists included similar key points in this initial consultation, although varied in how much detail they provided. Their discussion of treatment options included transplant and chemotherapy and less commonly supportive care or clinical trials. They often emphasized transplant's potential for cure, discussed transplant chronologically from pretransplant considerations through the post-transplant course, and outlined risks, complications, and major outcomes. Hematologists referred to several elements that formed the basis of treatment decision making. The strength of their treatment recommendations ranged from strong recommendations for transplant or chemotherapy to deferrals pending more information. Hematologists also varied in the extent to which they indicated the decision was physician-driven, patient-led, or shared. CONCLUSION The transplant decision-making discussion is complex. Identification of similar content areas used by hematologists can be used as the basis for a communication tool to help hematologists discuss allogeneic hematopoietic cell transplant with patients.

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“…This was also found in implementation studies in oncology. Although clinicians often discuss different options with pros and cons, they hardly ever elucidate patient preferences or apply these in reaching a decision [19][20]. A similar concern is SDM in patients presenting complex problems, e.g.…”

Section: Issues and Concerns At The Level Of Implementation In Routin...mentioning

confidence: 99%

Shared decision-making in the Netherlands: Progress is made, but not for all. Time to become inclusive to patients

Kraan

Brand

Veenendaal

et al. 2022

Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheit

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The Perception of Shared Decision‐Making in Hematology by Patients and Physicians Seems Satisfactory, but Important Steps are Still Ahead of Us

Abstract: Supplemental Digital Content is available in the text

Cited by 9 publications

References 16 publications

Patient‐centered communication tool for older patients with acute myeloid leukemia, their caregivers, and oncologists: A single‐arm pilot study

Patient‐centered communication tool for older patients with acute myeloid leukemia, their caregivers, and oncologists: A single‐arm pilot study

Communication Strategies of Transplant Hematologists in High-Risk Decision-Making Conversations

Shared decision-making in the Netherlands: Progress is made, but not for all. Time to become inclusive to patients

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