Which Decision Aids to Support Shared Decision Making Have the Potential to Improve Patient Outcomes in Palliative Lung- and Colorectal Cancer Care: Results from a Systematic Review

6581 Background: Advanced cancer is a leading cause of death in the US. While treatments have improved, patients still report physical, emotional, and financial burdens associated with the disease. In order to improve cancer care, a comprehensive examination of unmet needs among patients, health care professionals, and other stakeholders is required to develop interventions that can improve patient outcomes, experience, and reduce healthcare spending. Methods: A national convenience sample of patients, families, caregivers, healthcare professionals, payer groups, and healthcare delivery systems who have experience with cancer care were selected for participation. A 10-question survey was administered to participants regarding their experiences with current cancer care. A novel combination of Grounded theory, Stanford d.school and bio-design needs-findings methodologies were used to assess and prioritize needs. Results: A total of 273 participants presented 99 unique needs over the study period. Needs were organized into five categories: 1. Monitor/Intervene Patient Clinical and Symptom Data 2. Shared Decision-Making 3. Best Practice Communication 4. Integrated Care Team 5. Patient-Tailored Care. The most common needs of cancer patients were improved symptom control. Needs among providers focused on minimizing tasks that could be performed by others. Payer needs reflected improved value in care. Family and caregiver needs reflected shared decision-making in treatment plans. Healthcare delivery system needs included improved guideline development, evidence-based care, and report of quality metrics. Conclusions: A novel methodology to assess, analyze, and organize unmet needs in cancer care reveals that the top concerns among stakeholders are better symptom control, enhanced efforts to improve patient care commensurate with patients’ values, and a more tailored approach to coordinate care delivery using guideline-based care with attention to quality metrics. Future studies should draw upon these needs to develop targeted interventions for patients with advanced cancer that can improve experience, clinical outcomes, and reduce healthcare spending.

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A systematic review of decision aids that facilitate elements of shared decision-making in chronic illnesses: a review protocol

Systematic Reviews ◽

10.1186/s13643-017-0557-9 ◽

2017 ◽

Vol 6 (1) ◽

Cited By ~ 7

Author(s):

Thomas H. Wieringa ◽

Marleen Kunneman ◽

Rene Rodriguez-Gutierrez ◽

Victor M. Montori ◽

Maartje de Wit ◽

...

Keyword(s):

Systematic Review ◽

Decision Making ◽

Shared Decision Making ◽

Decision Aids ◽

Chronic Illnesses ◽

Shared Decision ◽

Review Protocol

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Lessons in Integrating Shared Decision-Making Into Cancer Care

Journal of Oncology Practice ◽

10.1200/jop.18.00019 ◽

2018 ◽

Vol 14 (4) ◽

pp. 229-235 ◽

Cited By ~ 18

Author(s):

Karina Dahl Steffensen ◽

Mette Vinter ◽

Dorthe Crüger ◽

Kathrina Dankl ◽

Angela Coulter ◽

...

Keyword(s):

Decision Making ◽

Shared Decision Making ◽

Cancer Care ◽

Care Delivery ◽

Decision Aids ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Shared Decision ◽

Care Needs ◽

Patient Reported

The benefits of shared decision-making (SDM) in health care delivery are well documented, but implementing SDM at the institutional level is challenging, particularly when patients have complex illnesses and care needs, as in cancer. Denmark’s Lillebaelt Hospital, in creating The Patient’s Cancer Hospital in Vejle, has learned key lessons in implementing SDM so that the organization’s culture is actually being transformed. In short, SDM is becoming part of the fabric of care, not a mere add-on to it. Specifically, the hospital chose and structured its leadership to ensure that SDM is constantly championed. It organized multiple demonstration projects focused on use of decision aids, patient-reported outcome measures, and better communication tools and practices. It designed programs to train clinicians in the art of doctor-patient communication. It used research evidence to inform development of the decision aids that its clinicians use with their patients. And it rigorously measured SDM performance in an ongoing fashion so that progress could be tracked and refined to ensure continuous improvement. Initial data on the institution’s SDM initiatives from the Danish national annual survey of patients’ experiences show substantial progress, thereby motivating Lillebaelt to reassert its commitment to the effort, to share what it has learned, and to invite dialogue among all cancer care organizations as they seek to fully integrate SDM in daily clinical practice.

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Are We Involving Patients in Shared Decision-Making in Young Adult Hip Surgery? A Systematic Review of Patient Engagement Initiatives in Hip Preservation

Journal of Patient Experience ◽

10.1177/2374373520956870 ◽

2020 ◽

Vol 7 (6) ◽

pp. 920-924

Author(s):

Aaron Alokozai ◽

David N Bernstein ◽

Linsen T Samuel ◽

Atul F Kamath

Keyword(s):

Systematic Review ◽

Decision Making ◽

Young Adults ◽

Shared Decision Making ◽

Patient Engagement ◽

Decision Aids ◽

Future Research ◽

Shared Decision ◽

Call To Action ◽

Hip Disease

There are limited published studies on patient engagement, including shared decision-making, in adolescents and young adults with complex congenital or post-traumatic hip disorders. Despite the limited number of papers, we aim to clearly summarize what is currently available in the literature using a systematic review approach. We hope this serves as a call to action and catalyst for more work in this field. Future research must focus on awareness of what matters most to patients (values), and the development, implementation, and barriers to the use of decision aids and patient engagement optimization specific to hip disease in young adults.

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