Abstract P6-12-06: Shared decision making (SDM) in routine care treatment of breast cancer patients - A survey of patients following surgery

Abstract

Abstract Introduction: The aim of shared decision making (SDM) is a treatment decision in which patients are meaningfully involved. Many preference-sensitive decisions have to be made in breast cancer treatment and little is known about the implementation of SDM. We therefore investigated the process of SDM in routine care treatment. Methods: All breast cancer patients who underwent surgery in four German breast centers between 07/2016 and 07/2018 were invited to take part. The experienced decision-making process was assessed using the German version of the 9-item SDM questionnaire (PEF-FB-9). Furthermore, satisfaction with care with focus on patient participation was assessed using the ZAPA questionnaire. PEF-FB-9 and ZAPA items were summed up and transformed into a total score ranging from 0 to 100. The higher the total score the higher the experienced degree of participation and satisfaction, respectively. Participants were asked to separately rate decision-making consultations with their inpatient hospital doctors, outpatient gynecologists, outpatient oncologists and primary care providers (PCP). In addition, satisfaction with decision, participation preferences as well as other items for the complete decision process were queried. Results: Of 1,068 approached patients, 563 with a median age of 62 (31-92) filled in the survey (response rate: 53%). 81% had breast conserving surgery, 19% mastectomy. Consultations were assessed most often for hospital doctors (n=484). Gynecologists (n=270), oncologists (n=174) and PCP (n=64) were evaluated less often. Hospital doctors (mean (M): 75, standard deviation (SD): 22) and oncologists (M: 74, SD: 22) achieved the highest PEF-FB-9 scores indicating the highest degree of SDM. Gynecologists and PCP were rated almost as good with mean scores of 71 (SD: 23) and 69 (SD: 28), respectively. The mean score for all groups of doctors was 74 (SD: 21), less than 4% of patients reported SDM scores <25. The values for satisfaction with decision were distributed as follows: PCP (M: 90, SD: 16), hospital doctors (M: 89, SD: 16), oncologists (M: 89, SD: 17), gynecologists (M: 85, SD: 22). Conclusions: Overall, patients reported to have experienced SDM in many situations where treatment decisions were necessary. Patients were quite satisfied with the quality of information and their participation in medical decisions. However, we do not know whether non-respondents might have had different experiences regarding their treatment decision-making. Citation Format: Rudolf Weide, Isabelle Scholl, Jan Dünnebacke, Marcus Schmidt, Arno Franzen, Walter Ernst, Ilhan Saka, Heike Spaderna, Stefan Feiten. Shared decision making (SDM) in routine care treatment of breast cancer patients - A survey of patients following surgery [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P6-12-06.