390 Developing a decision tool for skin cancer treatment in older adults

Abstract

Patient decision aids are designed to inform patients about the potential risks and benefits of available treatments. Decision tools can increase patient satisfaction and improve healthcare efficiency by better corresponding treatment received with patient treatment preferences. These are especially useful when several equivalent disease management options exist. This study aimed to develop a decision aid to assist older patients facing basal cell carcinoma (BCC) in their treatment decisions. We composed a brief, user-friendly, appealing, prototype decision aid suitable for use with older patients in accordance with the International Patient Decision Aid Standards. We modified it to ensure health literacy to 8th grade reading level. Based on successive input from patients, caregivers, and clinicians including dermatologists and dermatologic surgeons, the decision aid will be iteratively modified to incorporate feedback from all stakeholders. We will assess accessibility, bias, and usability through multiple rounds of focus groups and semi-structured interviews. Input from stakeholders will allow us to address all facets of the decision-making process, including: the emotional aspect of the fear associated with cancer, integrating the caregiver role, and the option to forego surgery in favor of less invasive options. The final product will then be subject to pilot testing in a clinical setting. The decision aid developed for this study is the first of its kind for BCCs in older adults. The decision aid appears feasible and comprehensible, and may serve as an effective means of encouraging active participation by patients in the clinical decision-making process.