Abstract
BackgroundMultidisciplinary team meetings and shared decision-making are potential means of delivering patient-centred care. Not much is known about how those two paradigms fit together in cancer care. This study aimed to investigate how decisions are made in multidisciplinary team meetings and whether patient perspectives are incorporated in these decisions.Materials and MethodsA qualitative study was conducted using non-participant observation at multidisciplinary team meetings (also called tumor boards) at the University Cancer Center Hamburg-Eppendorf, Germany. Two researchers recorded structured field notes from a total of N = 15 multidisciplinary team meetings. Data were analyzed using content analysis and descriptive statistics.ResultsPhysicians mainly exchanged medical information and based their decision-making on this information. Individual patient characteristics or their treatment preferences were rarely considered or discussed. In the few cases where patient preferences were raised as a topic, this information did not seem to be taken into account in decision-making processes about treatment recommendations.ConclusionThe processes in multidisciplinary team meetings we observed did not exhibit shared decision-making. Patient perspectives were absent. If multidisciplinary team meetings wish to become more patient-centred they will have to modify their processes and find a way to include patient preferences into the decision-making process.
Highlights
In the few cases where patient preferences were raised as a topic, this information did not seem to be taken into account in decision-making processes about treatment recommendations
Multidisciplinary care has become central to high quality cancer care, supported by many oncological associations and national cancer control plans [1, 2]
A systematic review by Lamb et al reveals that decisions in MDTMs are made by physicians, who primarily base their decision-making on biomedical information [7]
Summary
Multidisciplinary care has become central to high quality cancer care, supported by many oncological associations and national cancer control plans [1, 2]. MDTMs are organized for certain types of cancer and bring together the clinicians who are essential for diagnosis and treatment [4] They potentially enable interdisciplinary information exchange in order to find consensus on the best potential treatment options for one specific patient. A systematic review by Lamb et al reveals that decisions in MDTMs are made by physicians, who primarily base their decision-making on biomedical information [7]. Other information, such as patients’ psychosocial concerns or preferences, was often unknown or neglected [8]. This study aimed to investigate how decisions are made in multidisciplinary team meetings and whether patient perspectives are incorporated in these decisions
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