31 Background: Lung cancer is associated with significant distress, poor quality of life, and a median prognosis of less than one year. Shared decision making (SDM) has been recommended as a strategy to help guide patients facing difficult treatment trade-offs. Potential benefits of SDM include enhanced knowledge and better congruence between treatment decisions and patients’ personal values and have been described in multiple diseases. We investigated the impact of SDM on distress and healthcare utilization among patients with lung cancer. Methods: We performed a systematic literature search in the CINAHL, Cochrane, EMBASE, MEDLINE, and PsychINFO databases. Studies were eligible when conducted among patients with lung cancer, evaluated SDM, and measured distress and/or health care utilization as outcomes. Risk of bias was assessed using the Cochrane risk of bias tool. Results: A total of 11 articles were identified: two retrospective cohort studies and nine articles reporting on eight randomized controlled trials. Overall, the risk of bias of included studies was low, except for a high risk of bias concerning blinding of participants or personnel. All studies reported on a broad supportive care intervention with SDM as a component of the intervention. No beneficial effect was found in five studies measuring generic distress, while one study reported beneficial effects on depression. There was conflicting evidence regarding the effects of SDM on healthcare utilization; of the seven studies analyzing this, five studies found evidence for a reduction in healthcare utilization. Conclusions: Although relevant, only scarce evidence is currently available on the effects of SDM on distress and healthcare utilization among patients with lung cancer. Thus, additional research is needed before SDM can be recommended in the lung cancer context.
Health care utilization of patients with chronic obstructive pulmonary disease and lung cancer in the last 12 months of life