Clinicians’ experiences with patients with cancer or their families who endorse medical misinformation.

Abstract

11042 Background: Medical misinformation causes delays in cancer care, forgoing of treatment, economic harms, potentially toxic effects, and harmful medical interactions with standard curative treatments. Previous literature has examined patients’ traits and beliefs. However, effectively caring for patients with cancer who endorse medical misinformation also requires better understanding the experiences, competencies, and concerns of the clinicians who treat them. We conducted an IRB approved study of physicians and advanced practice providers at a large cancer center. Methods: We surveyed clinicians about following themes: i) prevalence of misinformation, ii) attitudes towards patients endorsing misinformation, iii) strategies and competence, iv) resources to help them successfully address patients. Results: 87 clinicians responded to the survey. The median response was 15% of patients endorse claims that are false or misleading about standard-of-care cancer treatments and 20% endorse claims that overstate the benefits or understate the risks of unconventional treatments. The most common misinformation concerned herbs and supplements. Clinicians ranked provides hope and poor medical literacy as the top reasons for why their patients endorse medical misinformation followed by distrust in conventional medicine, cultural factors, and religiosity. The primary attitude clinicians project to patients when they request unconventional treatments was Openness/Equanimity (75.6%), Curiosity (43.9%), Skepticism (18.3%), Disdain/Disappointment (0, 0.0%), Other (6.1%). The primary internal attitude clinicians experienced in these situations was Openness/Equanimity (25.6%), Skepticism (57.3%), Curiosity (40.2%), Disdain/Disappointment (22.0%), Other (6, 7.3%). When asked if they’d be open to a patient using a harmless unconventional treatment that had no evidence of therapeutic benefit, 17.1% said yes, 17.1% said no, and 65.9% said it depends. Correcting misinformation is difficult: 38.2% report success rates below 60% for correcting misinformation and 68.5% report success rates below 80%. Several factors contributed to low success: Only 26% said that they have enough time to adequately address patients who endorse misinformation. Moreover, 46.9% report insufficient resources, 65% claim insufficient training, and 51.3% claim insufficient institutional support. Conclusions: Many cancer care providers feel insufficiently trained and supported to address patients who endorse medical misinformation. Cancer care institutions must develop training and resources to help clinicians effectively address patients who endorse misinformation about their care.