- Title
- Single-arm longitudinal study to evaluate a decision aid for women offered Neoadjuvant systemic therapy for operable breast cancer
- Creator
- Zdenkowski, Nicholas; Butow, Phyllis; Spillane, Andrew; Douglas, Charles; Snook, Kylie; Jones, Mark; Oldmeadow, Christopher; Fewster, Sheryl; Beckmore, Corianna; Boyle, Francis M.
- Relation
- JNCCN Journal of the National Comprehensive Cancer Network Vol. 16, Issue 4, p. 378-385
- Publisher Link
- http://dx.doi.org/10.6004/jnccn.2017.7063
- Publisher
- Harborside Press
- Resource Type
- journal article
- Date
- 2018
- Description
- Background: Neoadjuvant systemic therapy (NAST) is an increasingly used treatment option for women with large operable or highly proliferative breast cancer. With equivalent survival outcomes between NAST and up-front surgery, the situation-specific preference-sensitive nature of the decision makes it suitable for a decision aid (DA). This study aimed to develop and evaluate a DA for this population. Methods: A DA booklet was developed according to international standards, including information about adjuvant and neoadjuvant treatment, outcome probabilities, and a values clarification exercise. Eligible women, considered by investigators as candidates for NAST, were enrolled in a multi-institutional, single-arm, longitudinal study. Patient-reported outcome measure questionnaires were completed pre- and post-DA, between chemotherapy and surgery, and at 12 months. Outcomes were feasibility (percentage of eligible patients accessing the DA); acceptability to patients (percentage who would recommend it to others) and clinicians (percentage who would use the DA in routine practice); and decision-related outcomes. Results: From 77 eligible women, 59 were enrolled, of whom 47 (79.7%; 95% CI, 69.4-89.9) reported having read the DA; 51 completed the first post-DA questionnaire. Of these 51, 41 participants (80.4%; 95% CI, 69.5-91.3) found the DA useful for their decision about NAST. Of 18 responding investigators, 16 (88.9%; 95% CI, 74.4-103.4) indicated they would continue to use the DA in routine practice. Post-DA, decisional conflict decreased significantly (P < .01); anxiety and distress decreased significantly; and 86.3% (95% CI, 73.7-94.3) achieved at least as much decisional control as they desired. Conclusions: This DA was feasible and acceptable to patients and clinicians, and improvement in decision-related outcomes was demonstrated when used in combination with clinical consultations. This DA could safely be implemented into routine practice for women considering NAST for operable breast cancer.
- Subject
- breast cancer; neoadjuvant systemic therapy; operable; longitudinal study; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1472405
- Identifier
- uon:48826
- Identifier
- ISSN:1540-1405
- Language
- eng
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Goal 3: Good Health and Well-Being