从口服抗凝药共同决策中汲取的经验教训:关于开发口服化疗决策辅助工具建议的观点。

IF 3.3 Q2 ONCOLOGY
JMIR Cancer Pub Date : 2024-09-11 DOI:10.2196/56935
Daniel E McLoughlin, Fabiola M Moreno Echevarria, Sherif M Badawy
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引用次数: 0

摘要

非结构化:口服化疗是常见的处方药,通过使用决策辅助工具(DAs),临床医生可以促进共同决策(SDM),使治疗选择与患者的目标和价值观保持一致。虽然已有商业化产品,但针对口服化疗的独特挑战开发决策辅助工具的证据却很少。为了填补这一文献空白,我们的目标是回顾为口服抗凝药开发的DA、DA在肿瘤学中的应用以及患者偏好调查,以指导口服化疗DA的开发。我们重点回顾了 SDM、患者偏好,特别是口服抗凝药和/或肿瘤用药的开发、疗效和/或患者体验,最终在我们的观点文章中纳入了来自 30 篇同行评审刊物的结论和数据。我们发现,口服抗凝药中有效的DAs能增进知识、降低决策冲突、提高依从性,并涵盖广泛的SDM要素;然而,患者体验方面的信息有限是一个普遍的缺陷。在肿瘤学领域,DAs 增加了知识并使决策与患者的价值观保持一致。效果不佳的肿瘤诊断书提供了笼统、不明确或过于乐观的信息,而提供 "过多 "的信息并不会造成伤害。患者更喜欢包含利弊、副作用、要问的问题以及预期生活质量变化的信息。在为口服化疗制定DAs时,应让患者参与制定过程,DAs的内容也应根据患者的喜好特别定制。事实证明,在预约前提供DAs比在预约期间提供DAs更有效,额外的考虑因素包括解决疗效障碍。有必要为考虑接受口服化疗的患者提供循证DA,以促进SDM。开发人员应利用口服抗凝药、肿瘤学和偏好调查的研究数据来优化 SDM。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Lessons Learned From Shared Decision-Making With Oral Anticoagulants: Viewpoint on Suggestions for the Development of Oral Chemotherapy Decision Aids.

Oral chemotherapy is commonly prescribed, and by using decision aids (DAs), clinicians can facilitate shared decision-making (SDM) to align treatment choices with patient goals and values. Although products exist commercially, little evidence informs the development of DAs targeting the unique challenges of oral chemotherapy. To address this gap in the literature, our objective was to review DAs developed for oral anticoagulation, DA use in oncology, and patient preference surveys to guide the development of DAs for oral chemotherapy. We focused on reviewing SDM, patient preferences, and specifically the development, efficacy, and patient experience of DAs in oral anticoagulation and oncologic conditions, ultimately including conclusions and data from 30 peer-reviewed publications in our viewpoint paper. We found that effective DAs in oral anticoagulation improved knowledge, lowered decisional conflict, increased adherence, and covered a broad range of SDM elements; however, limited information on patient experience was a common shortcoming. In oncology, DAs increased knowledge and aligned decisions with the values of the patients. Ineffective oncology DAs provided general, unclear, or overly optimistic information, while providing "too much" information was not shown to do harm. Patients preferred DAs that included pros and cons, side effects, questions to ask, and expected quality of life changes. In developing DAs for oral chemotherapy, patients should be included in the development process, and DA content should be specifically tailored to patient preferences. Providing DAs ahead of appointments proved more effective than during, and additional considerations included addressing barriers to efficacy. There is a need for evidence-based DAs to facilitate SDM for patients considering oral chemotherapy. Developers should use data from studies in oral anticoagulation, oncology, and preference surveys to optimize SDM.

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来源期刊
JMIR Cancer
JMIR Cancer ONCOLOGY-
CiteScore
4.10
自引率
0.00%
发文量
64
审稿时长
12 weeks
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