Engaging Patients with Late-Stage Non-Small Cell Lung Cancer in Shared Decision Making about Treatment.

Authors

Ronald E. Myers, PhD, DSW, Division of Population Science, Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA 19107, USAFollow
Shailesh M Advani, Data Scientist, Terasaki Institute of Biomedical Innovation, 1018 Westwood Blvd, Los Angeles, CA 90024, USA
Pamela Myers, Division of Population Science, Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA 19107, USAFollow
Preethi Selvan MPH Student, Division of Population Science, Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA 19107, USAFollow
Gregory Garber, MSW, LCSW, Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USAFollow
Brooke Worster, MD, Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USAFollow
Neal Flomenberg, MD, Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USAFollow
Andrew Chapman, DO, Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USAFollow
Ralph Zinner, Department of Medical Oncology, Markey Cancer Center, University of Kentucky, Lexington, KY 40536, USA

Document Type

Article

Publication Date

10-1-2021

Comments

This article is the author's final published version in Journal of Personalized Medicine, Volume 11, Issue 10, October 2021, Article number 998.

The published version is available at https://doi.org/10.3390/jpm11100998.

Copyright © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).

Abstract

Few treatment decision support interventions (DSIs) are available to engage patients diagnosed with late-stage non-small cell lung cancer (NSCLC) in treatment shared decision making (SDM). We designed a novel DSI that includes care plan cards and a companion patient preference clarification tool to assist in shared decision making. The cards answer common patient questions about treatment options (chemotherapy, chemotherapy plus immunotherapy, targeted therapy, immunotherapy, clinical trial participation, and supportive care). The form elicits patient treatment preference. We then conducted interviews with clinicians and patients to obtain feedback on the DSI. We also trained oncology nurse educators to implement the prototype. Finally, we pilot tested the DSI among five patients with NSCLC at the beginning of an office visit scheduled to discuss treatment with an oncologist. Analyses of pilot study baseline and exit survey data showed that DSI use was associated with increased patient awareness of the alternatives' treatment options and benefits/risks. In contrast, patient concern about treatment costs and uncertainty in treatment decision making decreased. All patients expressed a treatment preference. Future randomized controlled trials are needed to assess DSI implementation feasibility and efficacy in clinical care.

Recommended Citation

Myers, PhD, DSW, Ronald E.; Advani, Shailesh M; Myers, Pamela; Selvan, Preethi MPH Student; Garber, MSW, LCSW, Gregory; Worster, MD, Brooke; Flomenberg, MD, Neal; Chapman, DO, Andrew; and Zinner, Ralph, "Engaging Patients with Late-Stage Non-Small Cell Lung Cancer in Shared Decision Making about Treatment." (2021). Department of Medical Oncology Faculty Papers. Paper 156.
https://jdc.jefferson.edu/medoncfp/156

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 License.

PubMed ID

34683140

Language

English