Abstract
BackgroundThe current study aimed to further our understanding of second opinions among medical oncology patients by examining the proportion of patients who sought a second opinion about their cancer treatment, and why.MethodsThe study was conducted between 2013 and 2015 in three medical oncology clinics located in public hospitals in Australia: in metropolitan New South Wales, metropolitan Queensland, and in Tasmania.Those patients who provide written informed consent were asked to complete a brief paper and pencil survey in the clinic containing questions on sociodemographic, disease and treatment characteristics. Approximately 1 month later, participants were mailed a second paper and pencil survey which contained questions about whether they had sought a second opinion and their motivation for doing so. Non-responders were followed up by letter at 3 and 6 weeks.ResultsOf 823 patients screened for eligibility, 698 eligible patients, 612 provided consent.Of those who consented, 355 completed both the initial survey and the second survey and were included in the analyses. Of the 57 patients who sought a second opinion, the most frequent reasons given for doing so were the need for reassurance (49.1%) and the need to consider the range of treatment options (41.8%).Of the 297 (83.6%) participants who did not seek a second opinion, the main reason was confidence in the first doctor (88.7%). Only 3.1% patients did not know that they could ask for a second opinion. Occasionally the doctor will initiate the referral for a second opinion.ConclusionsOur study suggests that a minority of cancer patients seek a second opinion at some phase during their care. Most did so for reassurance or to ensure that they had covered all of the treatment options and not because of discomfort or distrust of their treating doctor.Few patients reported a lack of awareness of second opinions. This suggests that second opinions form part of a patient-centred approach to information provision about care options. Whether the second opinion improves the quality of care or indeed outcomes has been difficult to demonstrate.
Highlights
The current study aimed to further our understanding of second opinions among medical oncology patients by examining the proportion of patients who sought a second opinion about their cancer treatment, and why
355 completed both the initial survey and the second survey and were included in the analyses. Comparing those who completed both surveys to those who only completed the baseline survey, the non-completers were more often male (57% compared to 45% who completed, p < 0.051) and older (75% over 60 years compared to 46% for completers, p = 0.002) Of the patient characteristics, the age range reflects cancer incidence with over half of the participants aged over 60 years, and there was a good spread across the three treatment centres (Table 1)
Of the 57 (16.1%; 95% Confidence Interval (CI) 6.8 to 25.4%) patients who sought a second opinion, the most frequent reasons given for doing so were the need for reassurance (49.1%)
Summary
The current study aimed to further our understanding of second opinions among medical oncology patients by examining the proportion of patients who sought a second opinion about their cancer treatment, and why. A second opinion is defined as seeking an independent opinion on either diagnosis or treatment by an expert in the same field as the specialist who gave the initial opinion [1]. A second opinion can be sought by the patient, a specialist, a health institution or insurer. In contrast to the large literature on doctor-initiated second opinions, comparatively less attention has been given to patient-initiated second opinions. This is surprising as the principles of patient-centred care emphasise the need to inform patients about their options and to provide care that is responsive to their needs, values and preferences [2]. Consumers have recommended that information on the ‘possibility of a second opinion’ be considered an indicator of patient-centred care [3]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
