Engaging patients on tumor boards: A multi-stakeholder perspective study.

Abstract

e19243 Background: Patient and family-centered care (PFCC) is grounded in the concepts of dignity and respect, information sharing, and active participation and collaboration in their health care. Efforts to engage patients and family members as part of the healthcare team as part of robust multidisciplinary breast cancer care (MBCC), including in multidisciplinary tumor boards, is an extension of PFCC for breast cancer care. Our team explored multi-stakeholder perspectives of engaging patients as partners on a virtual multidisciplinary tumor board (MTB) using an mHealth application. Methods: We conducted a prospective cohort study employing semi-structured interviews and focus group methodology to explore stakeholder (patients with Stage 0-III breast cancer, family members/caregivers, clinicians, and tumor board staff) perspectives of engaging patients in a virtual MTB. Interviews and focus groups were audiotaped, transcribed, and analyzed using concurrent content analysis to identify common themes. Recruitment continued until saturation of themes was achieved. Results: We conducted 22 interviews and 5 focus groups with 49 participants. Patients and family members reported discomfort with idea of engaging in MTB discussions about their cancer. Disease burden, limited understanding of medical terminology, and not wanting to be a part of the early discussions about their disease (e.g., being overwhelmed, need to trust clinician’s advice) were commonly reported. Clinicians and staff also reported concerns about patient engagement in MTB. Clinicians reported that it may change the candor of the discussions at MTB and obfuscate the problems/issues if they needed to modify their language to accommodate patients’ sensitivities. Clinicians and staff were also concerned about patient’s perception of discordance within the MTB clinician members and how to explain this uncertainty to patients. Staff concerns centered around the use of medical terminology which may create anxiety and result in patient misunderstanding. Conclusions: Clinicians, staff, patients and family members were overwhelmingly concerned about adding patients to the MTB. Engaging patients in the frank and candid early treatment planning discussions may need further evaluation in a clinical environment and among different patient cohorts.