Decision aids for second-line palliative chemotherapy: a randomised phase II multicentre trial

Area of Science:

• Oncology
• Patient Decision Making
• Clinical Trials

Background:

• Palliative chemotherapy offers modest benefits but significant burdens for advanced cancer patients.
• Decision aids (DAs) may aid complex treatment choices, but information overload could negatively impact well-being.
• Evaluating the safety and efficacy of DAs in this context is crucial.

Purpose of the Study:

• To assess the safety and efficacy of decision aids (DAs) for patients with advanced cancer considering second-line chemotherapy.
• To determine if DAs impact patient well-being, decision quality, and treatment choice.

Main Methods:

• A randomized phase II study involving patients with advanced breast or colorectal cancer considering second-line chemotherapy.
• Patients were assigned to usual care or usual care plus a DA offering information on adverse events, response, and survival.
• Outcomes included patient-reported anxiety, decision-making quality, and choice.

Main Results:

• No adverse impact on patient well-being was observed with DA use.
• Patients offered DAs showed stronger treatment preferences and increased subjective knowledge.
• Objective knowledge, risk perception, and involvement were similar between groups.

Conclusions:

• Decision aids with detailed risk information can be safely used in advanced cancer palliative care.
• The impact of DAs on the decision-making process quality was modest.
• Further research is needed to explore the effectiveness of DAs for palliative treatment decisions.