A decision aid to assist in adjuvant therapy choices for breast cancer
Article first published online: 2 MAR 2006
Copyright © 2006 John Wiley & Sons, Ltd.
Volume 15, Issue 11, pages 1001–1013, November 2006
How to Cite
Siminoff, L. A., Gordon, N. H., Silverman, P., Budd, T. and Ravdin, P. M. (2006), A decision aid to assist in adjuvant therapy choices for breast cancer. Psycho-Oncology, 15: 1001–1013. doi: 10.1002/pon.1040
- Issue published online: 20 OCT 2006
- Article first published online: 2 MAR 2006
- Manuscript Accepted: 10 JAN 2006
- Manuscript Received: 13 JUN 2005
- National Cancer Institute. Grant Number: R01-HS08516
- breast cancer;
- decision making;
- patient participation;
- decision support techniques;
- adjuvant therapy
Background: Decision aids are tools that help patients make specific and deliberative choices among options. This study was a group randomized controlled trial of a novel decision aid to help patients with breast cancer make adjuvant therapy (AT) decisions.
Methods: Fourteen oncology practices (n=58 physicians) were randomized to receive the decision aid or a control pamphlet. Complete data were obtained from 405 patient–oncologist pairs. Eligible patients had stage I–III disease and had completed their primary treatment. The decision aid is a simple to use computer program, titled Adjuvant!, that provides estimates of outcome with and without AT. Graphical representations of outcome are shared with patients. Consultations were audiotaped, patients interviewed, and physicians completed a self-administered survey.
Results: In a multivariable model, the 54 patients (13.3%) who took no AT were more likely to have received the decision aid (p=0.02). A differential effect of the Adjuvant! Decision Guide was noted between node negative and positive patients. It was stated by 86.2% of patients that the decision aid was influential when making their treatment decision. Over 95% of patients reported that the Adjuvant Decision Guide was easy to understand and 75% of physicians believed that it helped them understand their patient's treatment preferences and 81.4% reported the information as useful for themselves.
Conclusions: This study showed that a decision aid made a difference in the choice of whether or not to take AT. The decision aid allowed patients and physicians to consider the benefits of AT in an easy to understand format. Treatment decisions were more individualized for patients in the intervention than in the control group. The use of the decision aid was acceptable to both patients and physicians. Copyright © 2006 John Wiley & Sons, Ltd.