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Effect of a multilevel implementation programme on shared decision-making in breast cancer care
H van Veenendaal1,2, H Voogdt-Pruis2,3, D T Ubbink4
1Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, the Netherlands.
BJS Open
|March 10, 2021
Summary
A multilevel implementation program improved clinician behavior in shared decision-making (SDM) for breast cancer patients. This enhances patient involvement in treatment choices, promoting better care outcomes.
Area of Science:
- Oncology
- Healthcare Implementation Science
- Patient-Centered Care
Background:
- Breast cancer patients have diverse treatment options, necessitating shared decision-making (SDM).
- Clinician adoption of SDM behaviors is crucial for effective patient involvement.
Purpose of the Study:
- To evaluate if a multilevel implementation program enhanced clinician SDM behavior in breast cancer consultations.
- To assess the impact of the program on patient-reported SDM levels.
Main Methods:
- A before-after study in six Dutch hospitals involving 139 breast cancer patients.
- Audio recordings of consultations analyzed using the Observing Patient Involvement in Decision-Making (OPTION-5) instrument.
- Patient-reported outcomes measured using the Shared Decision-Making Questionnaire (SDM-Q-9).
Main Results:
- Clinician SDM behavior scores (OPTION-5) significantly increased from 38.3 to 53.2 post-implementation.
- Patient-reported SDM (SDM-Q-9) remained high and showed no significant change.
- Implementation program, hospital, and consultation duration were associated with improved OPTION-5 scores.
Conclusions:
- A multilevel implementation program effectively enhanced clinician SDM behavior in breast cancer care.
- The findings support the integration of SDM support programs in oncology settings.
- Further research can explore long-term patient outcome impacts.
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