A pilot trial of decision aids to give truthful prognostic and treatment information to chemotherapy patients with advanced cancer

Thomas J Smith, Lindsay A. Dow, Enid A. Virago, James Khatcheressian, Robin Matsuyama, Laurel J. Lyckholm

Research output: Contribution to journalArticle

Abstract

Most cancer patients do not have an explicit discussion about prognosis and treatment despite documented adverse outcomes. Few decision aids have been developed to assist the difficult discussions of palliative management. We developed decision aids for people with advanced incurable breast, colorectal, lung, and hormone-refractory prostate cancers facing first-, second-, third-, and fourth-line chemotherapy. We recruited patients from our urban oncology clinic after gaining the permission of their treating oncologist. We measured knowledge of curability and treatment benefit before and after the intervention. Twenty-six of 27 (96%) patients completed the aids, with a mean age of 63, 56% female, 56% married, 56% African American, and 67% with a high school education or more. Most patients (14/27, 52%) thought a person with their advanced cancer could be cured, which was reduced (to 8/26, 31%, P = 0.15) after the decision aid. Nearly all overestimated the effect of palliative chemotherapy. No distress was noted, and hope did not change. The majority (20/27, 74%) found the information helpful to them, and almost all (25/27, 93%) wanted to share the information with their family and physicians. It is possible to give incurable patients their prognosis, treatment options, and options for improving end-of-life care without causing distress or lack of hope. Almost all find the information helpful and want to share it with doctors and family. Research is needed to test the findings in a larger sample and measure the outcomes of truthful information on quality of life, quality of care, and costs.

Original languageEnglish (US)
Pages (from-to)79-86
Number of pages8
JournalJournal of Supportive Oncology
Volume9
Issue number2
DOIs
StatePublished - Mar 2011
Externally publishedYes

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Decision Support Techniques
Hope
Drug Therapy
Neoplasms
Quality of Life
Therapeutics
Terminal Care
Quality of Health Care
Family Physicians
African Americans
Prostatic Neoplasms
Breast
Outcome Assessment (Health Care)
Hormones
Education
Costs and Cost Analysis
Lung
Research

ASJC Scopus subject areas

  • Oncology
  • Pharmacology (medical)

Cite this

A pilot trial of decision aids to give truthful prognostic and treatment information to chemotherapy patients with advanced cancer. / Smith, Thomas J; Dow, Lindsay A.; Virago, Enid A.; Khatcheressian, James; Matsuyama, Robin; Lyckholm, Laurel J.

In: Journal of Supportive Oncology, Vol. 9, No. 2, 03.2011, p. 79-86.

Research output: Contribution to journalArticle

Smith, Thomas J ; Dow, Lindsay A. ; Virago, Enid A. ; Khatcheressian, James ; Matsuyama, Robin ; Lyckholm, Laurel J. / A pilot trial of decision aids to give truthful prognostic and treatment information to chemotherapy patients with advanced cancer. In: Journal of Supportive Oncology. 2011 ; Vol. 9, No. 2. pp. 79-86.
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