The Influence of Non-Clinical Patient Factors on Medical Oncologists’ Decisions to Recommend Breast Cancer Adjuvant Chemotherapy
| Autor: | Steven J. Katz, T. May Pini, Jennifer J. Griggs, Yun Li, Sarah T. Hawley |
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| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty Michigan Multivariate analysis Population Decision Making Breast Neoplasms Medical Oncology Article Social support Breast cancer Internal medicine Epidemiology medicine Humans Practice Patterns Physicians' education Gynecology education.field_of_study business.industry Patient Selection Social environment Social Support Odds ratio medicine.disease Los Angeles Confidence interval Logistic Models Oncology Socioeconomic Factors Chemotherapy Adjuvant Health Care Surveys Multivariate Analysis Female business SEER Program |
| Popis: | The extent to which medical oncologists consider non-clinical patient factors when deciding to recommend adjuvant chemotherapy is unknown. Medical oncologists who treated a population-based sample of early stage breast cancer patients reported to the Los Angeles and Detroit Surveillance, Epidemiology, and End Results registries 2005-2007 were asked how strongly they consider a patient's ability to follow instructions, level of social support, and level of work support/flexibility in decisions to recommend adjuvant chemotherapy. Responses of 4 (Quite strongly) or 5 (Very strongly) on a five-point Likert scale defined strong consideration. Associations between oncologist/practice characteristics and strong consideration of each non-clinical factor were examined. 134 oncologists (66 %) reported strong consideration of one or more factor. Ability to follow instructions was strongly considered by 120 oncologists (59 %), social support by 78 (38 %), and work support/flexibility by 73 (36 %). Larger percent of practice devoted to breast cancer was associated with lower likelihood of strongly considering ability to follow instructions [odds ratio (OR) 0.98, 95 % confidence interval (CI) 0.97-0.99; P = 0.04]. Increased years in practice was associated with lower likelihood of strongly considering social support (OR 0.96, CI 0.93-0.99; P = 0.011), while non-white race (OR 2.1, CI 1.03-4.26; P = 0.041) and tumor board access (OR 2.04, CI 1.01-4.12; P = 0.048) were associated with higher likelihood. Non-white race was associated with strongly considering work support/flexibility (OR 2.44, CI 1.21-4.92; P = 0.013). Tumor board access (OR 2, CI 1.00-4.02; P = 0.051) was borderline significant. Non-clinical patient factors play a role in medical oncologist decision-making for breast cancer adjuvant chemotherapy recommendations. |
| Databáze: | OpenAIRE |
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