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Supportive Care in Cancer
Published in: Supportive Care in Cancer 5/2019

01-05-2019 | Care | Review Article

Barriers and facilitators to shared decision-making in oncology: a systematic review of the literature

Authors: Jordan R. Covvey, Khalid M. Kamal, Erin E. Gorse, Zumi Mehta, Trupti Dhumal, Elham Heidari, Deepika Rao, Christopher Zacker

Published in: Supportive Care in Cancer | Issue 5/2019

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Abstract

Purpose

Shared decision-making (SDM) is a strategy to facilitate patient-centered care and is increasingly important in oncology, where patients are faced with complicated treatment decisions that require them to weigh efficacy and safety, quality of life, and cost. Understanding the contributors to the use of SDM may provide insight to its further implementation. Therefore, the objective of the study was to examine the patient-related barriers/facilitators to SDM in oncology care.

Methods

A systematic literature review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was executed. A search strategy composed of cancer, decision-making, and patient-centered terms was conducted utilizing PubMed, EBSCO MEDLINE, Scopus, CINAHL, and the Cochrane Library databases between January 2007 and November 2017. Full-text, US-based, English language articles describing the patient perspective of SDM in oncology care were included. Relevant data from articles were reviewed in a qualitative synthesis.

Results

From 3435 potential citations, a total of 35 articles were included. The most common cancers studied were breast (n = 22; 62.9%) and prostate (n = 9; 25.7%). The identified themes for barriers to SDM were uncertainty in the treatment decision, concern regarding adverse effects, and poor physician communication. Themes for facilitators for SDM included physician consideration of patient preferences, positive physician actions and behaviors, and use or encouragement of support systems.

Conclusion

As SDM gains use within oncology practice, understanding key influences will allow for more effective implementation of strategies to increase patient engagement and improve care and value in the treatment process.
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Metadata
Title
Barriers and facilitators to shared decision-making in oncology: a systematic review of the literature
Authors
Jordan R. Covvey
Khalid M. Kamal
Erin E. Gorse
Zumi Mehta
Trupti Dhumal
Elham Heidari
Deepika Rao
Christopher Zacker
Publication date
01-05-2019
Publisher
Springer Berlin Heidelberg
Keyword
Care
Published in
Supportive Care in Cancer / Issue 5/2019
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-019-04675-7

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