Training for Medical Oncologists on Shared Decision-Making About Palliative Chemotherapy: A Randomized Controlled Trial

Autor: Hanneke C. J. M. de Haes, Ellen M. A. Smets, Hanneke W. M. van Laarhoven, Petronella B. Ottevanger, Marleen Kunneman, Pomme E. A. van Maarschalkerweerd, Serge E. Dohmen, Meltem Tokat, Ellen G. Engelhardt, Dirkje W. Sommeijer, Filip de Vos, Inge Henselmans, Geert Jan Creemers
Přispěvatelé: APH - Quality of Care, APH - Personalized Medicine, Medical Psychology, CCA - Cancer Treatment and Quality of Life, AGEM - Re-generation and cancer of the digestive system, Oncology, VU University medical center
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Adult
Male
Cancer Research
medicine.medical_specialty
Palliative care
Medical oncology
Decision Making
education
Patient assessment
Research Support
law.invention
03 medical and health sciences
All institutes and research themes of the Radboud University Medical Center
0302 clinical medicine
Primary outcome
Drug Therapy
Randomized controlled trial
law
Journal Article
Humans
Medicine
030212 general & internal medicine
Non-U.S. Gov't
Information provision
Shared decision-making
Oncologists
business.industry
Research Support
Non-U.S. Gov't
Communication
Palliative chemotherapy
Physician-patient relations
Advanced cancer
Women's cancers Radboud Institute for Health Sciences [Radboudumc 17]
Clinical Practice
Oncology
Symptom Management and Supportive Care
030220 oncology & carcinogenesis
Physical therapy
Female
business
Zdroj: Henselmans, I, van Laarhoven, H W M, de Haes, H C J M, Tokat, M, Engelhardt, E G, van Maarschalkerweerd, P E A, Kunneman, M, Ottevanger, P B, Dohmen, S E, Creemers, G-J, Sommeijer, D W, de Vos, F Y F L & Smets, E M A 2019, ' Training for Medical Oncologists on Shared Decision-Making About Palliative Chemotherapy: A Randomized Controlled Trial ', Oncologist, vol. 24, no. 2, pp. 259-265 . https://doi.org/10.1634/theoncologist.2018-0090
oncologist, 24(2), 259-265. AlphaMed Press
Oncologist, 24, 2, pp. 259-265
Oncologist, 24, 259-265
Oncologist, 24(2), 259-265. AlphaMed Press
Oncologist, 24(2), 259. AlphaMed Press
ISSN: 1083-7159
DOI: 10.1634/theoncologist.2018-0090
Popis: Background Systemic treatment for advanced cancer offers uncertain and sometimes limited benefit, while the burden can be high. This study examines the effect of shared decision-making (SDM) training for medical oncologists on observed SDM in standardized patient assessments. Materials and Methods A randomized controlled trial comparing training with standard practice was conducted. Medical oncologists and oncologists-in-training (n = 31) participated in a video-recorded, standardized patient assessment at baseline (T0) and after 4 months (T1, after training). The training was based on a four-stage SDM model and consisted of a reader, two group sessions (3.5 hours each), a booster session (1.5 hours), and a consultation card. The primary outcome was observed SDM as assessed with the Observing Patient Involvement scale (OPTION12) coded by observers blinded for arm. Secondary outcomes were observed SDM per stage, communication skills, and oncologists’ satisfaction with communication. Results The training had a significant and large effect on observed SDM in the simulated consultations (Cohen's f = 0.62) and improved observed SDM behavior in all four SDM stages (f = 0.39–0.72). The training improved oncologists’ information provision skills (f = 0.77), skills related to anticipating/responding to emotions (f = 0.42), and their satisfaction with the consultation (f = 0.53). Conclusion Training medical oncologists in SDM about palliative systemic treatment improves their performance in simulated consultations. The next step is to examine the effect of such training on SDM in clinical practice and on patient outcomes. Implications for Practice Systemic treatment for advanced cancer offers uncertain and sometimes limited benefit, while the burden can be high. Hence, applying the premises of shared decision-making (SDM) is recommended. SDM is increasingly advocated based on the ethical imperative to provide patient-centered care and the increasing evidence for beneficial patient outcomes. Few studies examined the effectiveness of SDM training in robust designs. This randomized controlled trial demonstrated that SDM training (10 hours) improves oncologists’ performance in consultations with standardized patients. The next step is to examine the effect of training on oncologists’ performance and patient outcomes in clinical practice.
Databáze: OpenAIRE
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