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BMC Palliative Care
Published in: BMC Palliative Care 1/2018

Open Access 01-12-2018 | Research article

The availability and effectiveness of tools supporting shared decision making in metastatic breast cancer care: a review

Authors: Inge Spronk, Jako S. Burgers, François G. Schellevis, Liesbeth M. van Vliet, Joke C. Korevaar

Published in: BMC Palliative Care | Issue 1/2018

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Abstract

Background

Shared decision-making (SDM) in the management of metastatic breast cancer care is associated with positive patient outcomes. In daily clinical practice, however, SDM is not fully integrated yet. Initiatives to improve the implementation of SDM would be helpful. The aim of this review was to assess the availability and effectiveness of tools supporting SDM in metastatic breast cancer care.

Methods

Literature databases were systematically searched for articles published since 2006 focusing on the development or evaluation of tools to improve information-provision and to support decision-making in metastatic breast cancer care. Internet searches and experts identified additional tools. Data from included tools were extracted and the evaluation of tools was appraised using the GRADE grading system.

Results

The literature search yielded five instruments. In addition, two tools were identified via internet searches and consultation of experts. Four tools were specifically developed for supporting SDM in metastatic breast cancer, the other three tools focused on metastatic cancer in general. Tools were mainly applicable across the care process, and usable for decisions on supportive care with or without chemotherapy. All tools were designed for patients to be used before a consultation with the physician. Effects on patient outcomes were generally weakly positive although most tools were not studied in well-designed studies.

Conclusions

Despite its recognized importance, only two tools were positively evaluated on effectiveness and are available to support patients with metastatic breast cancer in SDM. These tools show promising results in pilot studies and focus on different aspects of care. However, their effectiveness should be confirmed in well-designed studies before implementation in clinical practice. Innovation and development of SDM tools targeting clinicians as well as patients during a clinical encounter is recommended.
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Literature
1.
2.
Lux MP, Bayer CM, Loehberg CR, Fasching PA, Schrauder MG, Bani MR, et al. Shared decision-making in metastatic breast cancer: discrepancy between the expected prolongation of life and treatment efficacy between patients and physicians, and influencing factors. Breast Cancer Res Treat. 2013;139:429–40.CrossRefPubMed
3.
Leighl NB, Butow PN, Tattersall MH. Treatment decision aids in advanced cancer: when the goal is not cure and the answer is not clear. J Clin Oncol. 2004;22:1759–62.CrossRefPubMed
4.
Partridge AH, Rumble RB, Carey LA, Come SE, Davidson NE, Di Leo A, et al. Chemotherapy and targeted therapy for women with human epidermal growth factor receptor 2–negative (or unknown) advanced breast cancer: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol. 2014;32:3307–29.CrossRefPubMed
5.
Elwyn G, Laitner S, Coulter A, Walker E, Watson P, Thomson R. Implementing shared decision making in the NHS. BMJ. 2010;341:c5146.CrossRefPubMed
6.
Légaré F, Ratté S, Gravel K, Graham ID. Barriers and facilitators to implementing shared decision-making in clinical practice: update of a systematic review of health professionals’ perceptions. Patient Educ Couns. 2008;73:526–35.CrossRefPubMed
7.
Institute of Medicine. Delivering high-quality cancer care: charting a new course for a system in crisis. Washington, DC: National Academies Press; 2013.
8.
Degner LF, Sloan JA. Decision making during serious illness: what role do patients really want to play? J Clin Epidemiol. 1992;45:941–50.CrossRefPubMed
9.
Keating NL, Guadagnoli E, Landrum MB, Borbas C, Weeks JC. Treatment decision making in early-stage breast cancer: should surgeons match patients’ desired level of involvement? J Clin Oncol. 2002;20:1473–9.PubMed
10.
Gaston CM, Mitchell G. Information giving and decision-making in patients with advanced cancer: a systematic review. Soc Sci Med. 2005;61:2252–64.CrossRefPubMed
11.
Kehl KL, Landrum MB, Arora NK, Ganz PA, Van Ryn M, Mack JW, et al. Association of actual and preferred decision roles with patient-reported quality of care: shared decision making in cancer care. JAMA Oncol. 2015;1:50–8.CrossRefPubMedPubMedCentral
12.
13.
Kashaf MS, McGill E. Does shared decision making in cancer treatment improve quality of life? A systematic literature review. Med Decis Mak. 2015;35:1037–48.CrossRef
14.
Hargraves I, Montori VM. Decision aids, empowerment, and shared decision making. BMJ. 2014;349:g5811.CrossRefPubMed
15.
Stacey D, Bennett CL, Barry MJ, Col NF, Eden KB, Holmes-Rovner M, Thomson R. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev. 2011;10(10).
16.
Ozanne EM, Partridge A, Moy B, Ellis KJ, Sepucha KR. Doctor-patient communication about advance directives in metastatic breast cancer. J Palliat Med. 2009;12:547–53.CrossRefPubMed
17.
Elwyn G, Lloyd A, Joseph-Williams N, Cording E, Thomson R, Durand M-A, et al. Option grids: shared decision making made easier. Patient Educ Couns. 2013;90:207–12.CrossRefPubMed
18.
Stacey D, Légaré F, Lyddiatt A, Giguere AM, Yoganathan M, Saarimaki A, Tugwell P. Translating evidence to facilitate shared decision making: development and usability of a consult decision aid prototype. The Patient. 2016; 9(6):571–82.
19.
Elwyn G, O'Connor A, Stacey D, Volk R, Edwards A, Coulter A, et al. Developing a quality criteria framework for patient decision aids: online international Delphi consensus process. BMJ. 2006;333:417.CrossRefPubMedPubMedCentral
20.
Elwyn G, Edwards A, Hood K, Robling M, Atwell C, Russell I, et al. Achieving involvement: process outcomes from a cluster randomized trial of shared decision making skill development and use of risk communication aids in general practice. Fam Pract. 2004;21:337–46.CrossRefPubMed
21.
22.
Tang J, Shakespeare T, Lu J, Chan Y, Lee K, Wong L, et al. Patients’ preference for radiotherapy fractionation schedule in the palliation of symptomatic unresectable lung cancer. J Med Imaging Radiat Oncol. 2008;52:497–502.CrossRefPubMed
23.
Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008;336:924–6.CrossRefPubMedPubMedCentral
24.
Chiew KS, Shepherd H, Vardy J, Tattersall MH, Butow PN, Leighl NB. Development and evaluation of a decision aid for patients considering first-line chemotherapy for metastatic breast cancer. Health Expect. 2008;11:35–45.CrossRefPubMed
25.
Oostendorp LJ, Ottevanger PB, van de Wouw AJ, Schoenaker IJ, de Graaf H, van der Graaf WT, et al. Expected survival with and without second-line palliative chemotherapy: who wants to know? Health Expect. 2015;18:2903–14.CrossRefPubMed
26.
Oostendorp LJM, Ottevanger PB, van de Wouw AJ, Honkoop AH, Los M, van der Graaf WTA, et al. Patients’ preferences for information about the benefits and risks of second-line palliative chemotherapy and their oncologist's awareness of these preferences. J Cancer Educ. 2016;31:443–8.CrossRefPubMed
27.
Smith TJ, Dow LA, Virago EA, Khatcheressian J, Matsuyama R, Lyckholm LJ. A pilot trial of decision aids to give truthful prognostic and treatment information to chemotherapy patients with advanced cancer. J Support Oncol. 2011;9:79.CrossRefPubMedPubMedCentral
28.
Meropol NJ, Egleston BL, Buzaglo JS, Balshem A, Benson AB, Cegala DJ, et al. A web-based communication aid for patients with cancer. Cancer. 2013;119:1437–45.CrossRefPubMedPubMedCentral
29.
Oostendorp LJM, Ottevanger PB, Donders ART, Wouw AJ, Schoenaker IJH, Smilde TJ, et al. Decision aids for second-line palliative chemotherapy: a randomised phase II multicentre trial. BMC Med Inform Decis Mak. 2017;17:130.CrossRefPubMedPubMedCentral
30.
Sepucha KR, Ozanne EM, Partridge AH, Moy B. Is there a role for decision aids in advanced breast cancer? Med Decis Mak. 2009;29:475–82.CrossRef
31.
Department of Health. Equity and excellence: liberating the NHS. London: National Health Service; 2010.
32.
United States Federal Statute. The patient protection and affordable care act. Washington: US Government; 2010.
33.
Australian Commission on Safety and Quality in Health Care: National Statement on health literacy: taking action to improve safety and quality; 2014.
34.
Chow S, Teare G, Basky G. Shared decision making: helping the system and patients make quality health care decisions. Saskatchewan: Health Quality Council; 2009.
35.
Stiggelbout AM, Van der Weijden T, De Wit M, Frosch D, Légaré F, Montori VM, et al. Shared decision making: really putting patients at the Centre of healthcare. BMJ. 2012;344:e256.CrossRefPubMed
36.
Breslin M, Mullan RJ, Montori VM. The design of a decision aid about diabetes medications for use during the consultation with patients with type 2 diabetes. Patient Educ Couns. 2008;73:465–72.CrossRefPubMed
37.
Elwyn G, Frosch D, Volandes AE, Edwards A, Montori VM. Investing in deliberation: a definition and classification of decision support interventions for people facing difficult health decisions. Med Decis Mak. 2010;30:701–11.CrossRef
38.
Joseph-Williams N, Newcombe R, Politi M, Durand M-A, Sivell S, Stacey D, et al. Toward minimum standards for certifying patient decision aids: a modified Delphi consensus process. Med Decis Mak. 2014;34:699–710.CrossRef
39.
Durand M-A, Witt J, Joseph-Williams N, Newcombe RG, Politi MC, Sivell S, et al. Minimum standards for the certification of patient decision support interventions: feasibility and application. Patient Educ Couns. 2015;98:462–8.CrossRefPubMed
40.
Montori VM, LeBlanc A, Buchholz A, Stilwell DL, Tsapas A. Basing information on comprehensive, critically appraised, and up-to-date syntheses of the scientific evidence: a quality dimension of the international patient decision aid standards. BMC Med Inform Decis Mak. 2013;13:S5.CrossRefPubMedPubMedCentral
41.
42.
Lloyd A, Joseph-Williams N, Edwards A, Rix A, Elwyn G. Patchy ‘coherence’: using normalization process theory to evaluate a multi-faceted shared decision making implementation program (MAGIC). Implement Sci. 2013;8:102.CrossRefPubMedPubMedCentral
43.
Joseph-Williams N, Elwyn G, Edwards A. Knowledge is not power for patients: a systematic review and thematic synthesis of patient-reported barriers and facilitators to shared decision making. Patient Educ Couns. 2014;94:291–309.CrossRefPubMed
44.
O’Brien MA, Ellis PM, Whelan TJ, Charles C, Gafni A, Lovrics P, et al. Physician-related facilitators and barriers to patient involvement in treatment decision making in early stage breast cancer: perspectives of physicians and patients. Health Expect. 2013;16:373–84.CrossRefPubMed
45.
Belcher VN, Fried TR, Agostini JV, Tinetti ME. Views of older adults on patient participation in medication-related decision making. J Gen Intern Med. 2006;21:298–303.CrossRefPubMedPubMedCentral
Metadata
Title
The availability and effectiveness of tools supporting shared decision making in metastatic breast cancer care: a review
Authors
Inge Spronk
Jako S. Burgers
François G. Schellevis
Liesbeth M. van Vliet
Joke C. Korevaar
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Palliative Care / Issue 1/2018
Electronic ISSN: 1472-684X
DOI
https://doi.org/10.1186/s12904-018-0330-4

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