Prioritisation of treatment goals among older patients with non-curable cancer: the OPTion randomised controlled trial in Dutch primary care.
aged
decision making
general practice
neoplasms
palliative care
primary health care
Journal
The British journal of general practice : the journal of the Royal College of General Practitioners
ISSN: 1478-5242
Titre abrégé: Br J Gen Pract
Pays: England
ID NLM: 9005323
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
received:
13
09
2019
accepted:
12
12
2019
pubmed:
3
6
2020
medline:
25
6
2021
entrez:
3
6
2020
Statut:
epublish
Résumé
Older patients with cancer often find it difficult to take part in shared decision making. To assess the utility of the Outcome Prioritisation Tool (OPT), designed to aid discussion with a patient in regards to their treatment goals, to empower patients with cancer through structured conversations about generic treatment goals with GPs. A randomised controlled trial of 114 Dutch participants recruited between November 2015 and January 2019, aged ≥60 years with non-curable cancer who had to make a treatment decision with an oncologist. The intervention group used the OPT while the control group received care as usual. The primary outcome was patient empowerment using the score on the decision self-efficacy (DSE) scale. Secondary outcomes were symptoms measures of fatigue, anxiety, and depression. The experiences of participants were also explored. No effect was found on patient empowerment between the OPT group ( An OPT-facilitated conversation about generic treatment goals between patients and their GPs is associated with less anxiety and fatigue, but did not show statistically significant improvements in patient empowerment. Adding the OPT to routine care might ensure more patient-tailored care.
Sections du résumé
BACKGROUND
Older patients with cancer often find it difficult to take part in shared decision making.
AIM
To assess the utility of the Outcome Prioritisation Tool (OPT), designed to aid discussion with a patient in regards to their treatment goals, to empower patients with cancer through structured conversations about generic treatment goals with GPs.
DESIGN AND SETTING
A randomised controlled trial of 114 Dutch participants recruited between November 2015 and January 2019, aged ≥60 years with non-curable cancer who had to make a treatment decision with an oncologist. The intervention group used the OPT while the control group received care as usual.
METHOD
The primary outcome was patient empowerment using the score on the decision self-efficacy (DSE) scale. Secondary outcomes were symptoms measures of fatigue, anxiety, and depression. The experiences of participants were also explored.
RESULTS
No effect was found on patient empowerment between the OPT group (
CONCLUSION
An OPT-facilitated conversation about generic treatment goals between patients and their GPs is associated with less anxiety and fatigue, but did not show statistically significant improvements in patient empowerment. Adding the OPT to routine care might ensure more patient-tailored care.
Identifiants
pubmed: 32482626
pii: bjgp20X710405
doi: 10.3399/bjgp20X710405
pmc: PMC7274544
doi:
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e450-e456Informations de copyright
© British Journal of General Practice 2020.
Références
Onkologie. 2003 Apr;26(2):140-4
pubmed: 12771522
Eur J Cancer. 2018 Nov;103:356-387
pubmed: 30100160
Onkologie. 2013;36(7-8):403-7
pubmed: 23921758
Scand J Prim Health Care. 2014 Jun;32(2):55-61
pubmed: 24931639
Support Care Cancer. 2012 Apr;20(4):705-14
pubmed: 21437780
Psychooncology. 2013 Sep;22(9):2095-101
pubmed: 23463726
Eur J Cancer Care (Engl). 2019 Jan;28(1):e12898
pubmed: 30039883
BMJ. 2012 Jan 27;344:e256
pubmed: 22286508
Health Expect. 2015 Aug;18(4):542-61
pubmed: 23451939
Support Care Cancer. 2013 Aug;21(8):2217-23
pubmed: 23503801
Health Qual Life Outcomes. 2008 Jul 02;6:46
pubmed: 18597689
Patient Educ Couns. 2015 Oct;98(10):1172-9
pubmed: 26215573
Patient Educ Couns. 2012 Jan;86(1):9-18
pubmed: 21474265
Eur J Cancer Care (Engl). 2017 May;26(3):
pubmed: 28488327
J Clin Oncol. 2009 Jun 10;27(17):2758-65
pubmed: 19403886
ESMO Open. 2016 Apr 12;1(3):e000020
pubmed: 27843603
Maturitas. 2019 Oct;128:49-52
pubmed: 31561823
Am J Clin Oncol. 1982 Dec;5(6):649-55
pubmed: 7165009
Lancet Oncol. 2015 Sep;16(12):1231-72
pubmed: 26431866
Patient Educ Couns. 2011 May;83(2):278-82
pubmed: 20570078
Lancet. 1994 Oct 22;344(8930):1129-33
pubmed: 7934497
Patient Educ Couns. 2014 Mar;94(3):291-309
pubmed: 24305642
Psychooncology. 2016 Apr;25(4):362-86
pubmed: 26387480
Am J Hosp Palliat Care. 2010 Dec;27(8):518-25
pubmed: 20834031
J Chronic Dis. 1987;40(5):373-83
pubmed: 3558716
Cochrane Database Syst Rev. 2014 Jan 28;(1):CD001431
pubmed: 24470076
J Cancer Educ. 2019 Aug;34(4):803-809
pubmed: 29862441
Acta Psychiatr Scand. 1983 Jun;67(6):361-70
pubmed: 6880820
J Am Geriatr Soc. 2016 Nov;64(11):e143-e148
pubmed: 27612181
Patient Prefer Adherence. 2018 Apr 23;12:615-624
pubmed: 29731609
J Am Soc Nephrol. 2018 Dec;29(12):2870-2878
pubmed: 30385652
J Clin Epidemiol. 2007 Jan;60(1):34-42
pubmed: 17161752
J Psychosom Res. 1995 Apr;39(3):315-25
pubmed: 7636775
Cancer Treat Rev. 2015 Feb;41(2):197-215
pubmed: 25579752
Chem Biol Interact. 2001 Jun 1;135-136:653-64
pubmed: 11397419
Eur J Cancer. 2017 Feb;72:37-45
pubmed: 28024265
Maturitas. 2017 Feb;96:84-88
pubmed: 28041600
Br J Cancer. 1996 Jan;73(2):241-5
pubmed: 8546913