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Patient Educ Couns. 2019 Nov;102(11):1961-1968. doi: 10.1016/j.pec.2019.05.018. Epub 2019 May 16.

A prospective cohort study of shared decision making in lung cancer diagnostics: Impact of using a patient decision aid.

Author information

1
Department of Internal Medicine, The Lung Cancer Diagnostic Organization, Lillebaelt Hospital, Vejle, Denmark. Electronic address: stine.rauff.sondergaard@rsyd.dk.
2
Department of Internal Medicine, Lillebaelt Hospital, Kolding, Denmark.
3
Department of Internal Medicine, The Lung Cancer Diagnostic Organization, Lillebaelt Hospital, Vejle, Denmark; Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
4
Department of Internal Medicine, The Lung Cancer Diagnostic Organization, Lillebaelt Hospital, Vejle, Denmark.
5
Center for Shared Decision Making, Lillebaelt Hospital, Vejle, Denmark.
6
Department of Oncology, Lillebaelt Hospital, Vejle, Denmark; Center for Shared Decision Making, Lillebaelt Hospital, Vejle, Denmark; Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.

Abstract

OBJECTIVE:

The objective of this study was to describe the impact on patient-reported outcomes of introducing Shared Decision Making (SDM) and a Patient Decision Aid (PtDA) in the initial process of lung cancer diagnostics.

METHODS:

We conducted a prospective cohort study, where a control cohort was consulted according to usual clinical practice. After introducing SDM through a PtDA and training of the staff, the SDM cohort was enrolled in the study. All patients completed four questionnaires: the Decisional Conflict Scale (DCS) before and after the consultation, the CollaboRATE scale after the consultation, and the Decision Regret Scale (DRS).

RESULTS:

Patients exposed to SDM and a PtDA had significantly improved DCS scores after the consultation compared to the control group (a difference of 10.26, p = 0.0128) and significantly lower DRS scores (a difference of 8.98, p = 0.0197). Of the 82 control patients and 52 SDM patients 29% and 54%, respectively, gave the maximum score on the CollaboRATE scale (Pearson's chi2 8.0946, p = 0.004).

CONCLUSION:

The use of SDM and a PtDA had significant positive impact on patient-reported outcomes.

PRACTICE IMPLICATIONS:

Our results may encourage the increased uptake of SDM in the initial process of lung cancer diagnostics.

KEYWORDS:

CollaboRATE; Decisional conflict; Decisional regret; Lung cancer diagnostics; Patient decision aid; Shared decision making

PMID:
31129012
DOI:
10.1016/j.pec.2019.05.018

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