Study reveals physicians should include patients in decisions about cancer care
Patients with cancer were more likely to report they received better quality of care if they had a role in their treatment decisions, according to a recent survey. The authors analyzed decisions regarding surgery, chemotherapy and/or radiation therapy as well as how patients rated physician communication.
Results were published online in JAMA Oncology [doi:10.1001/jamaoncol.2014.112].
The authors examined the responses of 5,315 patients who were diagnosed with lung and/or colorectal cancer between 2003 and 2005 and participated in the Cancer Care Outcomes Research and Surveillance Consortium. The patients lived in Northern California, Los Angeles County, North Carolina, Iowa and Alabama or received care in one of five health maintenance organizations or 15 Veterans Affairs sites. They were surveyed 3 to 6 months after diagnosis.
After receiving treatments, patients reported their perceptions on the quality of care and were asked about physician communication and their preferred roles in decision-making.
Of the patients, 56 percent had colorectal cancer, 40 percent had non-small-cell lung cancer and 5 percent had small cell lung cancer. Further, 58 percent said they preferred share roles in decision-making with physicians, 36 percent preferred controlling their own decisions and 6 percent preferred physicians control the decisions.
In 67.8 percent of treatments, patients reported physicians delivered “excellent” care, while 55.8 percent of patients gave their physicians the highest possible rating for communication.
After adjusting for variables, patients were less likely to report they had “excellent” care if physicians controlled the treatment decisions compared with when patients and physicians shared in the decision-making (odds ratio [OR], 0.64; P<.001). Patients were also less likely to provide a top rating for physician communication if physicians controlled the decisions than if there was shared decision-making (OR, 0.55; P=.002).
“Given the increasing emphasis on patient experiences and ratings in health care, these results highlight the benefits of promoting shared decision making among all patients with cancer, even those who express preferences for less active roles,” the authors wrote.
Executive Editor
Tim Casey joined TriMed Media Group in 2015 as Executive Editor. For the previous four years, he worked as an editor and writer for HMP Communications, primarily focused on covering managed care issues and reporting from medical and health care conferences. He was also a staff reporter at the Sacramento Bee for more than four years covering professional, college and high school sports. He earned his undergraduate degree in psychology from the University of Notre Dame and his MBA degree from Georgetown University.