Short summary

Shared decision making and the use of patient decision aids are important elements of patient involvement. We will examine how, when and in which format patient decision aids and patient-reported measures within shared decision making are of most benefit to the patient and the process of shared decision making.

Rationale

Most previous studies have focused on patient decision aids used either within the consultation or delivered pre-consultation, but there are no RCT studies comparing the two. There is a lack of evidence of the impact of patient decison aids used pre-consultation versus in-consult, as timing and format of the patient decision aid intervention may affect how useful the tool is to the patient. The aim of this project is therefore to deepen our understanding of the patient's engagement in and preparation for the decision making process in a randomised, controlled trial comparing a digital pre-consultation and paper-based in-consult patient decision aid.

Due to national clinical guidelines, cancer patients are treated very similarly, and patient pathways are generally the same nationwide. While the guidelines aim to offer all patients the same treatment options, there is still a decision to be made for the individual patient based on his or her life situation and preferences. This project is therefore an important contribution in understanding how to support the patient in this decision, and how the availability of patient decision aids influences the patient's experience of involvement and readiness to contribute in the decision-making process.

Description of the cohort

Patients over 18 years of age with historically verified breast or colorectal cancer, respectively, are enrolled in the study. Eligible patients will have a diagnosis of breast or colon cancer. All patients enrolled in the study are currently involved in a cancer pathway at the Department of Oncology at Vejle Hospital - part of Lillebaelt Hospital.

Data and biological material

In the study's method and analysis, we will examine the degree of patient involvement and readiness from three different perspectives - the patient's, the clinician's and the observer's:

The patient's perspective is measured by using six questionnaires on SDM: SDM Process_4, SDM-Q-9, Preparation for Decision Making, Decisional Conflict Scale, Collaborate, Control Preference Scale as well as patient characteristics and demographic data. The clinician's perspective is measured using the questionnaire SDM-Q-Doc.

Based on audio recordings of the conversations between clinician and patient, it will be possible to measure the degree of SDM seen from an observer's perspective using OPTION5. Based on the audio recordings, the length of consultation will be measured in both groups.

Collaborating researchers and departments

Center for Shared Decision Making, Lillebaelt Hospital

• Karina Dahl Steffensen
• Stine Rauff Søndergaard

School of Nursing, University of Ottawa, The Ottawa Hospital Research Institute, Ottawa, Canada

• Dawn Stacey