Artikel
Decision aids for second-line palliative chemotherapy: a randomised multicentre trial
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Veröffentlicht: | 23. Februar 2016 |
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Gliederung
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Background: Few decision aids (DAs) are available to support patients with advanced cancer in treatment decision-making. This randomised study evaluated safety and efficacy of DAs on second-line chemotherapy for advanced breast or colorectal cancer.
Methods: 45 patients were randomised to usual care and 83 patients to usual care plus a DA. Using the DA, nurses offered information on adverse events, tumour response and survival. Patients completed questionnaires to assess safety (primary outcome: anxiety) and efficacy in terms of quality of the decision-making process and the resulting choice.
Findings: The DAs did not adversely affect patients’ well-being, including anxiety. Patients in the DA group tended to be more in favour of chemotherapy (96% vs. 84%; p=0.067), but eventually 88% and 84% of patients started chemotherapy (p=0.746). Patients in the DA group had stronger treatment preferences (3.0 vs. 2.5; p=0.030) and higher subjective knowledge (6.7 vs. 6.3; p=0.022). No differences were seen in objective knowledge, risk perception or patient involvement.
Discussion: DAs with outcome information on second-line treatment could be safely offered to patients. Only some improvements in the quality of the decision-making process and the resulting choice were found. Future studies might clarify whether this relative lack of effects is common for palliative treatment decisions.