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Bridging the care gap: patients’ needs and experiences regarding shared decision-making in radiotherapy

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Title: Bridging the care gap: patients’ needs and experiences regarding shared decision-making in radiotherapy
Authors: A.R. van Hienen, C.J.W. Offermann, L.J. Boersma, M.J.G. Jacobs, R.R.R. Fijten
Source: Clinical and Translational Radiation Oncology, Vol 50, Iss , Pp 100897- (2025)
Publisher Information: Elsevier, 2025.
Publication Year: 2025
Collection: LCC:Medical physics. Medical radiology. Nuclear medicine
LCC:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Subject Terms: Shared Decision Making, Patient Preference, Physicians, Neoplasms, Educational Status, Patient Reported Outcome Measures, Medical physics. Medical radiology. Nuclear medicine, R895-920, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
More Details: Background and purpose: Shared decision-making (SDM), a collaborative process in which patients and physicians jointly determine further treatment, has been associated with numerous positive effects. However, its implementation into routine clinical practice faces challenges. In radiotherapy (RT) it may have additional challenges, since patients are referred from another oncologist, often “to undergo RT”. The aim of this study is to understand patients’ preferences and experiences regarding SDM at an academic RT clinic, and to identify targets for SDM implementation in RT. Materials and methods: We adapted an earlier survey sent out by the Dutch Cancer Patient Organizations Federation to fit the RT setting. The survey was distributed via letters and social media to (former) patients who had their intake between 2020 and 2022. Results: 1799 participants completed the survey, of whom 88,3% mentioned to always or often prefer SDM. 23,1% of participants reported experiencing a choice, and 50% of these participants experienced multiple options. The most commons reason for preferring SDM was bodily autonomy (n = 1114) and against SDM was wanting to decide themselves instead (n = 11). Participants with a higher educational attainment were more likely to prefer and experience SDM. Older participants were more likely to experience multiple options. Conclusion: Our findings reaffirm that most cancer patients prefer SDM, and extend these findings to RT. However, we found a large gap between patients’ desire for SDM, and the SDM experienced in our RT institute. SDM implementation strategies are needed and should focus on overcoming RT-specific and patient-reported barriers and opportunities.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2405-6308
Relation: http://www.sciencedirect.com/science/article/pii/S2405630824001745; https://doaj.org/toc/2405-6308
DOI: 10.1016/j.ctro.2024.100897
Access URL: https://doaj.org/article/45243b356c6a4662a0c134e01a9aee36
Accession Number: edsdoj.45243b356c6a4662a0c134e01a9aee36
Database: Directory of Open Access Journals
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  Data: Background and purpose: Shared decision-making (SDM), a collaborative process in which patients and physicians jointly determine further treatment, has been associated with numerous positive effects. However, its implementation into routine clinical practice faces challenges. In radiotherapy (RT) it may have additional challenges, since patients are referred from another oncologist, often “to undergo RT”. The aim of this study is to understand patients’ preferences and experiences regarding SDM at an academic RT clinic, and to identify targets for SDM implementation in RT. Materials and methods: We adapted an earlier survey sent out by the Dutch Cancer Patient Organizations Federation to fit the RT setting. The survey was distributed via letters and social media to (former) patients who had their intake between 2020 and 2022. Results: 1799 participants completed the survey, of whom 88,3% mentioned to always or often prefer SDM. 23,1% of participants reported experiencing a choice, and 50% of these participants experienced multiple options. The most commons reason for preferring SDM was bodily autonomy (n = 1114) and against SDM was wanting to decide themselves instead (n = 11). Participants with a higher educational attainment were more likely to prefer and experience SDM. Older participants were more likely to experience multiple options. Conclusion: Our findings reaffirm that most cancer patients prefer SDM, and extend these findings to RT. However, we found a large gap between patients’ desire for SDM, and the SDM experienced in our RT institute. SDM implementation strategies are needed and should focus on overcoming RT-specific and patient-reported barriers and opportunities.
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