Implementation of a Novel Patient Decision Aid for Women with Elevated Breast Cancer Risk Who Are Considering MRI Screening: A Pilot Study.

Autor: Chu CD; University of Virginia School of Nursing, Charlottesville, VA, USA. cdm9b@virginia.edu., Smith CE; Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA, USA., Gorski J; Sentara Healthcare, Norfolk, VA, USA., Smolkin M; Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA., Zhao H; James Madison University School of Nursing, Harrisonburg, VA, USA., Jones RA; University of Virginia School of Nursing, Charlottesville, VA, USA., Hollen P; University of Virginia School of Nursing, Charlottesville, VA, USA., Dengel LT; Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA, USA.
Jazyk: angličtina
Zdroj: Annals of surgical oncology [Ann Surg Oncol] 2023 Oct; Vol. 30 (10), pp. 6152-6158. Date of Electronic Publication: 2023 Jul 28.
DOI: 10.1245/s10434-023-13901-w
Abstrakt: Purpose: To determine the feasibility and acceptability of using a patient decision aid (DA) for women with elevated breast cancer risk who are considering MRI screening.
Methods: This pilot study employed a mixed methods design to develop, modify, and test an interactive DA. The DA was administered among a consecutive patient sample with an estimated Tyrer-Cuzick v.8 lifetime breast cancer risk of 20% or greater and without a pathologic genetic mutation. The decisional conflict scale was used to measure decisional conflict. Post-intervention provider and patient feedback evaluated shared decision-making, feasibility, and acceptability.
Results: Twenty-four patients participated, with a median age of 44 years. Prior to DA use, sixteen patients (67%) were unsure whether to add MRI to their screening, six patients elected MRI (25%), and two patients declined MRI (8%). Following DA use, thirteen of sixteen of the initially undecided participants (81%) established a preference, with eleven electing to add MRI screening. Of participants with an initial preference, all maintained the same decision following use of the DA. Prior to the DA, the median decisional conflict score among participants was 25% (range 0-60%) compared with 0% (range 0-25%) after the DA. Healthcare providers reported that the DA was useful and easily incorporated into clinical workflow.
Conclusions: This pilot study shows that there may be a benefit to DA utilization in the high-risk breast cancer clinic to guide shared decision-making in establishing a screening preference. The findings warrant further research to test the use of the DA in a larger, multi-site trial.
(© 2023. Society of Surgical Oncology.)
Databáze: MEDLINE
Externí odkaz: