Communication Strategies of Transplant Hematologists in High-Risk Decision-Making Conversations

Area of Science:

• Hematology
• Oncology
• Medical Communication

Background:

• Shared decision making (SDM) is crucial for blood cancer patients undergoing allogeneic hematopoietic cell transplantation (HCT).
• Empowering patients to make goal-concordant decisions is essential in this high-risk setting.

Purpose of the Study:

• To characterize communication strategies hematologists use during discussions about allogeneic HCT.
• To identify elements facilitating SDM in blood cancer treatment.

Main Methods:

• Recruited US hematologists performing allogeneic HCT.
• Analyzed video-recorded consultations between hematologists and an actor portraying a patient with myelodysplastic syndrome.
• Utilized qualitative analysis of transcribed data.

Main Results:

• Participants (N=37) discussed transplant, chemotherapy, and sometimes supportive care or clinical trials.
• Hematologists emphasized HCT's cure potential, discussed the process chronologically, and outlined risks and outcomes.
• Varied approaches were observed in detailing information and in the degree of shared, physician-led, or patient-led decision-making.

Conclusions:

• Allogeneic HCT decision-making discussions are complex.
• Identifying common content areas can inform the development of communication tools for hematologists.
• Improved communication strategies can enhance SDM for HCT in blood cancer patients.