Predictors of satisfaction with decision in patients with advanced cancer.

Abstract

9045 Background: Treatment decisions in palliative cancer care depend on various patient-, treatment, and disease-related factors. This study investigated patients’ satisfaction with decision and decision-making preferences in a Swiss oncology network and evaluated factors that predict satisfaction with decision (SWD). Methods: Patients receiving a new line of palliative cancer treatment completed a multi-dimensional questionnaire 4-6 weeks after treatment decision. Patient-reports comprised socio-demographic information, satisfaction with decision (primary endpoint), subjective treatment goal, preferences for decision-making, health, locus of control, and several quality of life (QoL) domains. Information on diagnosis, line of therapy, metastases, prognosis, performance status and duration of consultation were provided by the attending physician. Predictors of SWD (range: 0=worst; 30=best) were evaluated by uni- and multivariate (primary analysis, 80% power, 5% significance level) regression models. We consider ≥24 points as high SWD. Results: 445 out of 480 patients treated in 8 hospitals and 2 private practices completed all questions regarding the primary endpoint. 44% of patients preferred shared-, 42% physician-centered decision making. Median duration of consultation was 30 minutes (range 10-200 minutes). Overall, 326 (73%) patients reported high SWD. In univariate analyses various factors (e.g. global and physical QoL, performance status, treatment goal, locus of control, prognosis and duration of consultation) were significant predictors of SWD. The only significant predictor in the multivariate analysis was duration of consultation, which was positively associated with SWD (p=0.01). Conclusions: SWD is generally high in patients with advanced cancer treated in an oncology network in Switzerland. Our results indicate that duration of consultation is a very important factor among many others in predicting SWD. In busy clinical practice, taking your time with patients may be a simple measure to enhance patients’ SWD.