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Effects of a time out consultation with the general practitioner on cancer treatment decision‐making: a randomised controlled trial: Time out with the general practitioner and cancer treatment decision

OBJECTIVE: Improving shared decision‐making (SDM) enables more tailored cancer treatment decisions. We evaluated a Time Out consultation (TOC) with the general practitioner (GP), between cancer diagnosis and treatment decision, which aims at supporting SDM and improving continuity of primary care. T...

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Detalles Bibliográficos
Autores principales: Perfors, Ietje A.A., Noteboom, Eveline A., de Wit, Niek J., van der Wall, Elsken, Visserman, Ella A., van Dalen, Thijs, Verhagen, Marc A.M.T., Witkamp, Arjen J., Koelemij, Ron, Flinterman, Annebeth E., van Dorst, Eleonora B.L., Pruissen‐Peeters, Kim A.B.M., Moons, Leon M.G., Schramel, Franz M.N.H., van Rens, Marcel T.M., Ernst, Miranda F., May, Anne M., Helsper, Charles W.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8048675/
https://www.ncbi.nlm.nih.gov/pubmed/33245150
http://dx.doi.org/10.1002/pon.5604
Descripción
Sumario:OBJECTIVE: Improving shared decision‐making (SDM) enables more tailored cancer treatment decisions. We evaluated a Time Out consultation (TOC) with the general practitioner (GP), between cancer diagnosis and treatment decision, which aims at supporting SDM and improving continuity of primary care. This study aims to evaluate the effects of a TOC on perceived SDM, information provision and self‐efficacy. METHODS: This randomised controlled trial included newly diagnosed patients with curable cancer (breast, lung, colorectal, gynaecologic and melanoma) from four Dutch hospitals. Primary outcome is perceived SDM and secondary outcomes are information provision and self‐efficacy. RESULTS: One hundred fifty‐four patients (control n = 77, intervention n = 77) – female: 75%, mean age: 61 (SD ± 11.9). In the intervention group, 80.5% (n = 62) had a TOC, of which 82.3% (n = 51) took place after treatment decision. Perceived SDM was lower in the intervention group (−8.9 [95% CI: 0.6–17.1]). Among those with a TOC before treatment decision (n = 11), perceived SDM was comparable to the control group (66.5 ± 27.2 vs. 67.9 ± 26.1). CONCLUSION: Even though patients are motivated to have a TOC, implementing a TOC between diagnosis and treatment decision is challenging. Effects of a timely TOC could not be established. Non‐timely TOC decreased perceived SDM. Planning of the TOC should be optimised, and future research should establish if adequately timed TOC results in improved SDM in cancer patients.