Evaluation of the Implementation of the Dutch Breast Cancer Surveillance Decision Aid including Personalized Risk Estimates in the SHOUT-BC Study: A Mixed Methods Approach.

Autor: Ankersmid JW; Department of Health Technology and Services Research, University of Twente, 7522 NB Enschede, The Netherlands.; Santeon, 3584 AA Utrecht, The Netherlands., Engelhardt EG; Santeon, 3584 AA Utrecht, The Netherlands., Lansink Rotgerink FK; Santeon, 3584 AA Utrecht, The Netherlands., The R; ZorgKeuzeLab, 2611 BN Delft, The Netherlands., Strobbe LJA; Department of Surgery, Canisius Wilhelmina Hospital, 6532 SZ Nijmegen, The Netherlands., Drossaert CHC; Department of Psychology, Health & Technology, University of Twente, 7522 NB Enschede, The Netherlands., Siesling S; Department of Health Technology and Services Research, University of Twente, 7522 NB Enschede, The Netherlands.; Department of Research and Development, Netherlands Comprehensive Cancer Organisation, 3501 DB Utrecht, The Netherlands., van Uden-Kraan CF; Santeon, 3584 AA Utrecht, The Netherlands.
Jazyk: angličtina
Zdroj: Cancers [Cancers (Basel)] 2024 Mar 31; Vol. 16 (7). Date of Electronic Publication: 2024 Mar 31.
DOI: 10.3390/cancers16071390
Abstrakt: Background: To improve Shared decision-making (SDM) regarding personalized post-treatment surveillance, the Breast Cancer Surveillance Decision Aid (BCS-PtDA), integrating personalized risk information, was developed and implemented in eight hospitals. The aim of this mixed-methods study was to (1) assess the implementation and participation rates, (2) identify facilitators and barriers for use by health care professionals (HCPs), (3) quantify the observed level of SDM, and (4) evaluate risk communication and SDM application in consultations.
Methods: Implementation and participation rates and patients' BCS-PtDA use were calculated using hospital registry data and BCS-PtDA log data. HCPs' perspective on facilitators and barriers were collected using the MIDI framework. Observed SDM levels in consultation transcripts were quantified using the OPTION-5 scale. Thematic analysis was performed to assess consultation content.
Results: The average PtDA implementation and participation rates were, respectively, 26% and 61%. HCPs reported that the PtDA supported choice awareness. Reported barriers for implementation were mainly increased workload and a lack of perceived benefits. The consultation analysis ( n = 64) showed patients were offered a choice, but deliberation was lacking. Risk communication was generally adequate.
Discussion: When the BCS-PtDA was used, patients were clearly given a choice regarding their post-treatment surveillance, but information provision and SDM application can be improved.
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje