Evaluation of the Implementation of the Dutch Breast Cancer Surveillance Decision Aid including Personalized Risk Estimates in the SHOUT-BC Study: A Mixed Methods Approach

Jet W. Ankersmid*, Ellen G. Engelhardt, Fleur K. Lansink Rotgerink, Regina The, Luc J.A. Strobbe, Constance H.C. Drossaert, Sabine Siesling, Cornelia F. van Uden-Kraan, on behalf of the Santeon VBHC Breast Cancer Group

*Corresponding author for this work

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Abstract

Background: To improve Shared decision-making (SDM) regarding personalized post-treatment surveillance, the Breast Cancer Surveillance Decision Aid (BCS-PtDA), integrating personalized risk information, was developed and implemented in eight hospitals. The aim of this mixed-methods study was to (1) assess the implementation and participation rates, (2) identify facilitators and barriers for use by health care professionals (HCPs), (3) quantify the observed level of SDM, and (4) evaluate risk communication and SDM application in consultations. Methods: Implementation and participation rates and patients’ BCS-PtDA use were calculated using hospital registry data and BCS-PtDA log data. HCPs’ perspective on facilitators and barriers were collected using the MIDI framework. Observed SDM levels in consultation transcripts were quantified using the OPTION-5 scale. Thematic analysis was performed to assess consultation content. Results: The average PtDA implementation and participation rates were, respectively, 26% and 61%. HCPs reported that the PtDA supported choice awareness. Reported barriers for implementation were mainly increased workload and a lack of perceived benefits. The consultation analysis (n = 64) showed patients were offered a choice, but deliberation was lacking. Risk communication was generally adequate. Discussion: When the BCS-PtDA was used, patients were clearly given a choice regarding their post-treatment surveillance, but information provision and SDM application can be improved.

Original languageEnglish
Article number1390
JournalCancers
Volume16
Issue number7
DOIs
Publication statusPublished - 31 Mar 2024

Keywords

  • Breast cancer (BC)
  • Follow-up
  • OUTcome information
  • Post-treatment surveillance
  • PtDA
  • Risk communication
  • Shared decision-making (SDM)

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