A Nationwide Survey on Knowledge, Attitudes, and Practices of Filipino Oncologists and Oncology-Related Professionals on Shared Decision Making.

Abstract

Aim: To explore the knowledge, attitudes, and practices of Filipino oncologists and oncology-related professionals on shared decision making (SDM), evaluate their familiarity with and use of evidence-based medicine (EBM) and clinical practice guidelines (CPG), and identify barriers and facilitators to SDM.

Methods: A cross-sectional, nationwide online survey was conducted from April 1 to May 15, 2024, using voluntary response sampling.

Results: 87 respondents participated. Most practice in the National Capital Region (NCR) (n = 48, 55%), Luzon (outside NCR) (n = 22, 25%), Mindanao (n = 11, 13%), and Visayas (n = 8, 9%); 56 (64%) practice in both government and private centers. Most lacked a full conceptual understanding of SDM. Almost all had a positive attitude toward its implementation. 62 (71%) indicated that they share responsibility with their patients for making decisions. The top reason for not applying SDM in appropriate situations was patient deference to the clinician's decision (n = 37, 43%). Choosing among treatment options with equivalent effectiveness but different toxicity profiles (n = 86, 99%) was the most reported situation deemed appropriate for SDM. Key barriers to SDM implementation were patient-related factors, family dynamics, health financing, and time constraints. Several expressed the need for adequate time and effective communication to facilitate SDM.

Conclusion: Most surveyed Filipino oncologists and oncology-related professionals reported applying SDM and had a positive attitude toward it. However, a fuller conceptual understanding of the process is lacking. Patient-, family-, and health financing-related barriers were identified. Enhancing SDM education among oncologists may improve the clinical application, and exploring the perspectives of other stakeholders may enhance its institutionalization.