Time as a Resource in Involving Patients in Cancer Treatment Decision Making: An Interview Study

Time is often seen as a barrier to shared decision making (SDM). It is unclear how time can be a resource for patient involvement in routine cancer treatment decision-making processes and how time may be used more effectively.

To determine how time is reported to be used to facilitate patient involvement, when time is experienced to be most constrained, and how time may be used more effectively.

Semi-structured interviews with patients and physicians were held. Patients who had faced treatment decisions for primary treatment of acute myeloid leukemia or adjuvant treatment for colon cancer were included. We chose these diagnoses because patients face a decision between two medically reasonable treatment options, the amount of time available for decision making markedly differs between the two diagnoses, and patients with solid and non-solid tumors may perceive the role of time differently. Interviews were recorded, transcribed verbatim, and analyzed using thematic analysis.

We interviewed 18 Patients and 23 physicians. We identified three themes: (1) preparing for the decision-making consultation, (2) time to spend together, and (3) time to arrive at a decision. We divided each theme into two subthemes.

Patients differ in the time they need for decision making. It became clear that time is not a guarantee for a better decision-making process. Patients are not always choice aware, and rather perceive the decision as self-evident. Future research should focus on how to effectively raise patient choice awareness and allocate time in decision-making processes more effectively.