Using patient and physician perspectives to develop a shared decision-making framework for colorectal cancer

Area of Science:

• Oncology
• Health Services Research
• Qualitative Research

Background:

• Colorectal cancer is a leading global cause of cancer death, with over 900,000 diagnoses annually.
• Shared decision-making (SDM) is advocated for patient-centered care, but its application in colorectal cancer lacks thorough investigation.
• Patient and physician preferences and practices in SDM for colorectal cancer are not well understood.

Purpose of the Study:

• To determine patient and physician attitudes towards shared decision-making in colorectal cancer care.
• To identify factors influencing the SDM process and its outcomes in colorectal cancer.
• To establish a framework for evaluating SDM strategies in oncology.

Main Methods:

• Qualitative research employing semi-structured interviews with 60 colorectal cancer patients and 45 oncologists/surgeons across three tertiary care hospitals.
• Interviews guided by a conceptual framework on SDM factors and outcomes in colorectal cancer.
• Inductive, grounded analysis of interview transcripts by two independent investigators to identify themes, barriers, and enablers of SDM.

Main Results:

• The study is the first to examine both patient and physician perspectives on SDM in colorectal cancer care in North America.
• Identified key patient and physician factors influencing the shared decision-making process.
• Established a framework to describe the SDM process and its outcomes in colorectal cancer.

Conclusions:

• This research provides novel insights into patient and physician perspectives on shared decision-making in colorectal cancer.
• The developed framework can guide the description and evaluation of SDM interventions.
• Findings will inform strategies to enhance shared decision-making, improving patient-centered care for individuals with colorectal cancer.