Shared Decision Making in Oncology and Its Implementation in Cervical Cancer Management in the Philippines: A Narrative Review.

Autor:	Bacorro W; Graduate School, University of Santo Tomas, Manila, Philippines.; Department of Clinical Epidemiology, University of Santo Tomas-Faculty of Medicine and Surgery, Manila, Philippines.; Department of Radiation Oncology, University of Santo Tomas Hospital-Benavides Cancer Institute, Manila, Philippines., Short M; UniSA Allied Health and Human Performance, University of South Australia, Adelaide, Australia., Baldivia K; Department of Radiation Oncology, University of Santo Tomas Hospital-Benavides Cancer Institute, Manila, Philippines., Mariano J; Department of Obstetrics and Gynecology, University of Santo Tomas-Faculty of Medicine and Surgery, Manila, Philippines.; Department of Obstetrics and Gynecology, University of Santo Tomas Hospital, Manila, Philippines., Bautista A; Department of Obstetrics and Gynecology, Manila Doctors Hospital, Manila, Philippines., Amparo G; Department of Obstetrics and Gynecology, Our Lady of Lourdes Hospital, Manila, Philippines., Tagayuna I; Department of Obstetrics and Gynecology, De Los Santos Medical Center, Quezon City, Philippines., Jainar CJ; Department of Radiation Oncology, University of Santo Tomas Hospital-Benavides Cancer Institute, Manila, Philippines., Antonio L; Department of Radiation Oncology, University of Santo Tomas Hospital-Benavides Cancer Institute, Manila, Philippines., Dancel E; Department of Radiation Oncology, University of Santo Tomas Hospital-Benavides Cancer Institute, Manila, Philippines., Ortin TS; Department of Radiation Oncology, University of Santo Tomas Hospital-Benavides Cancer Institute, Manila, Philippines., Gonzalez G; Department of Obstetrics and Gynecology, University of Santo Tomas-Faculty of Medicine and Surgery, Manila, Philippines.; Department of Obstetrics and Gynecology, University of Santo Tomas Hospital, Manila, Philippines., Canlas R; Graduate School, University of Santo Tomas, Manila, Philippines.; Department of Psychology, University of Santo Tomas-College of Science, Manila, Philippines.
Jazyk:	angličtina
Zdroj:	JCO global oncology [JCO Glob Oncol] 2024 May; Vol. 10, pp. e2300486.
DOI:	10.1200/GO.23.00486
Abstrakt:	Purpose: Shared decision making (SDM) is an approach where clinicians and patients make decisions together using the best available evidence. Although much studied, recognized to be ethically imperative, and recommended in international health policies, it remains poorly implemented. In the Philippines, there are limited studies on patient decision making preferences and SDM. Practical guidance on the implementation of SDM or use of patient decision aids (PtDAs) is often not detailed in existing national clinical practice guidelines in oncology. Methods: We performed a systematic search of Philippine literature on SDM in oncology and an iterative review of international literature on the philosophy and methods of SDM, the utility and effectiveness of PtDAs, and the facilitators and barriers to implementation or usage. We contextualized our review to the cervical cancer management and health service delivery in the Philippines. Results: Local literature is limited to five scientific publications and two registered studies. International literature encompasses patient decisional preferences, the role of PtDAs and the standards for their development and evaluation, their effectiveness, and barriers and facilitators to their use in cancer-related decision making. We discussed the implications on the management of cervical cancer in the Philippines, challenges in health service delivery and standards, and SDM research. Conclusion: Local SDM research is limited. Our preliminary experience in a multicenter clinical trial in Manila on PtDA use in the framework of SDM in cervical cancer suggest good patient and clinician acceptability. Challenges to implementation such as unfavorable financial situations, urgency of clinical decisions, low patient or caregiver educational attainment, and poor integration of multidisciplinary and SDM in organizational workflows will be important when implementing SDM in different settings.
Databáze:	MEDLINE
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