Pharmacotherapy decision-making among patients with breast cancer in Japan: results of an online survey.

Abstract

Although communication between patients with breast cancer and physicians is central to treatment decision-making for patients and the concept of shared decision-making has been increasingly advocated worldwide, little is known about decision-making and perceptions among the population in Japan. Therefore, this cross-sectional study aimed to clarify the status of pharmacotherapy decision-making among patients with breast cancer in Japan and assess factors associated with patient satisfaction with patient-physician communication. Data for women previously treated with pharmacotherapy agents for breast cancer in Japan were collected in July 2017 using an online survey. Respondents were categorized by their decision-making role (active, shared, passive). Characteristics, decisional conflict level, and satisfaction with communication with their physician at the time of pharmacotherapy selection were stratified by decision-making roles. Stepwise multivariate logistic regression was performed to assess factors associated with satisfaction. Of 486 women that responded, nearly half played an active decision-making role (48.4%) and 26.0% played a shared role. The lowest decisional conflict and higher satisfaction were observed among those who played a shared role. The highest decisional conflict and lower satisfaction were observed in passive decision-makers. Shared decision-making, a longer consultation time with the physician, and multiple treatment options provided by the physician were significantly associated with satisfaction with communication with the physician. Our findings suggest that among patients with breast cancer, a shared role in treatment decision-making, longer consultation time at treatment selection, and having multiple treatment options are important for higher patient satisfaction with communication with their physician.