gms | German Medical Science

Gemeinsam informiert entscheiden: 17. Jahrestagung des Deutschen Netzwerks Evidenzbasierte Medizin

Deutsches Netzwerk Evidenzbasierte Medizin e.V.

03.03. - 05.03.2016, Köln

Decision aids for second-line palliative chemotherapy: a randomised multicentre trial

Meeting Abstract

  • Linda Oostendorp - RadboudUMC, Nijmegen, Niederlande
  • Nelleke Ottevanger - RadboudUMC, Nijmegen, Niederlande
  • Rogier Donders - RadboudUMC, Nijmegen, Niederlande
  • Agnes van der Wouw - VieCuri MC, Venlo, Niederlande
  • Ivonne Schoenaker - Isala Clinic, Zwolle, Niederlande
  • Tineke Smilde - Jeroen Bosch, Den Bosch, Niederlande
  • Winette van der Graaf - RadboudUMC, Nijmegen, Niederlande
  • corresponding author presenting/speaker Peep Stalmeier - RadboudUMC, Nijmegen, Niederlande

Gemeinsam informiert entscheiden. 17. Jahrestagung des Deutschen Netzwerks Evidenzbasierte Medizin. Köln, 03.-05.03.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. Doc16ebmB3a

doi: 10.3205/16ebm005, urn:nbn:de:0183-16ebm0050

Published: February 23, 2016

© 2016 Oostendorp et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at



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.