Effects of a time out consultation with the general practitioner on cancer treatment decision-making: a randomised controlled trial Time out with the general practitioner and cancer treatment decision

被引:12
作者
Perfors, Ietje A. A. [1 ]
Noteboom, Eveline A. [1 ]
de Wit, Niek J. [1 ]
van der Wall, Elsken [1 ]
Visserman, Ella A. [2 ]
van Dalen, Thijs [3 ]
Verhagen, Marc A. M. T. [3 ]
Witkamp, Arjen J. [1 ]
Koelemij, Ron [4 ]
Flinterman, Annebeth E. [3 ]
van Dorst, Eleonora B. L. [1 ]
Pruissen-Peeters, Kim A. B. M. [4 ]
Moons, Leon M. G. [1 ]
Schramel, Franz M. N. H. [4 ]
van Rens, Marcel T. M. [3 ]
Ernst, Miranda F. [5 ]
May, Anne M. [1 ]
Helsper, Charles W. [1 ]
机构
[1] Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, Internal Med & Oncol, Surg,Gynaecol Oncol,Gastroenterol, Utrecht, Netherlands
[2] Dutch Federat Canc Patient Org, Qual Care, Utrecht, Netherlands
[3] Diakonessenhuis Utrecht, Surg, Gastroenterol, Dermatol,Pulmonol, Utrecht, Netherlands
[4] St Antonius Hosp, Surg, Dermatol, Lung Dis & Treatment, Nieuwegein, Netherlands
[5] Alexander Monro Clin, Surg, Bilthoven, Netherlands
关键词
cancer; decision‐ making; general practitioners; neoplasms; physicians; primary health care; psycho‐ oncology; PRIMARY-CARE; PREFERENCES; BREAST; PHYSICIANS; OUTCOMES;
D O I
10.1002/pon.5604
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Objective Improving shared decision-making (SDM) enables more tailored cancer treatment decisions. We evaluated a Time Out consultation (TOC) with the general practitioner (GP), between cancer diagnosis and treatment decision, which aims at supporting SDM and improving continuity of primary care. This study aims to evaluate the effects of a TOC on perceived SDM, information provision and self-efficacy. Methods This randomised controlled trial included newly diagnosed patients with curable cancer (breast, lung, colorectal, gynaecologic and melanoma) from four Dutch hospitals. Primary outcome is perceived SDM and secondary outcomes are information provision and self-efficacy. Results One hundred fifty-four patients (control n = 77, intervention n = 77) - female: 75%, mean age: 61 (SD +/- 11.9). In the intervention group, 80.5% (n = 62) had a TOC, of which 82.3% (n = 51) took place after treatment decision. Perceived SDM was lower in the intervention group (-8.9 [95% CI: 0.6-17.1]). Among those with a TOC before treatment decision (n = 11), perceived SDM was comparable to the control group (66.5 +/- 27.2 vs. 67.9 +/- 26.1). Conclusion Even though patients are motivated to have a TOC, implementing a TOC between diagnosis and treatment decision is challenging. Effects of a timely TOC could not be established. Non-timely TOC decreased perceived SDM. Planning of the TOC should be optimised, and future research should establish if adequately timed TOC results in improved SDM in cancer patients.
引用
收藏
页码:571 / 580
页数:10
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