Shared decision-making supported by outcome information regarding surveillance after curative treatment for breast cancer: Results of the SHOUT-BC study

IF 7.6 1区医学 Q1 ONCOLOGY

European Journal of Cancer Pub Date : 2024-11-02 DOI:10.1016/j.ejca.2024.115107

J.W. Ankersmid , C.H.C. Drossaert , L.J.A. Strobbe , M.Q.N. Hackert , N. Engels , J.C.M. Prick , S. Teerenstra , Y.E.A. van Riet , R. The , C.F. van Uden-Kraan , S. Siesling , on behalf of the Santeon VBHC Breast Cancer Group

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引用次数: 0

Abstract

Background

Integrating outcome information into the process of shared decision-making (SDM) about post-treatment surveillance can enhance its effectiveness. The Breast Cancer Surveillance Decision Aid (BCS-PtDA) integrates risk estimations of patients’ risks for recurrences as well as outcome information on fear of cancer recurrence (FCR). The SHOUT-BC study aimed to evaluate the effectiveness of the implementation of the BCS-PtDA. Patients’ satisfaction with the BCS-PtDA was also evaluated.

Methods

As described in a previously published protocol paper, the study employed a Prospective multiple interrupted time series (ITS) design in which the BCS-PtDA was implemented stepwise into the care pathways of eight Dutch hospitals.

Results

A total of 507 participants completed a questionnaire after their first surveillance consultation which usually takes place approximately one year after surgery. ITS analysis per hospital and subsequent meta-analysis over hospital effects indicated a significant increase in patient-reported SDM from pre- to post-implementation (overall estimated effect: 27.14, 95 % CI: 22.71 to 31.87, p < .0001). Moreover, post-implementation participants (n = 225) reported a more active role in decision-making, decreased decisional conflict, and increased knowledge on the aim and methods of surveillance. Furthermore, a decrease in FCR was seen post-implementation. The self-reported intensity of surveillance schedules decreased slightly and the BCS-PtDA received highly positive evaluations.

Discussion

The implementation of the BCS-PtDA, which integrates outcome information, led to increased patient-reported SDM and an improved quality of decision-making. The BCS-PtDA was evaluated highly positively by participants. Further research should address optimisation of the implementation.

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乳腺癌根治性治疗后监测结果信息支持的共同决策：SHOUT-BC研究的结果

背景将结果信息纳入有关治疗后监测的共同决策（SDM）过程可提高其有效性。乳腺癌监测决策辅助工具（BCS-PtDA）整合了对患者复发风险的估计以及对癌症复发恐惧（FCR）的结果信息。SHOUT-BC研究旨在评估BCS-PtDA的实施效果。结果共有 507 名参与者在首次监测咨询（通常在术后一年左右）后填写了调查问卷。每家医院的 ITS 分析和随后的医院效应荟萃分析表明，从实施前到实施后，患者报告的 SDM 显著增加（总体估计效应：27.14，95 % CI：22.71 至 31.87，p < .0001）。此外，实施后的参与者（n = 225）表示在决策中扮演了更积极的角色，减少了决策冲突，增加了对监测目的和方法的了解。此外，FCR 在实施后也有所下降。讨论整合了结果信息的 BCS-PtDA 的实施增加了患者报告的 SDM，提高了决策质量。参与者对 BCS-PtDA 的评价非常积极。进一步的研究应解决实施过程中的优化问题。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Cancer 医学-肿瘤学

CiteScore

11.50

自引率

4.80%

发文量

953

审稿时长

23 days

期刊介绍： The European Journal of Cancer (EJC) serves as a comprehensive platform integrating preclinical, digital, translational, and clinical research across the spectrum of cancer. From epidemiology, carcinogenesis, and biology to groundbreaking innovations in cancer treatment and patient care, the journal covers a wide array of topics. We publish original research, reviews, previews, editorial comments, and correspondence, fostering dialogue and advancement in the fight against cancer. Join us in our mission to drive progress and improve outcomes in cancer research and patient care.