Background
Methods
Systematic search
Search strategy
Study selection
Inclusion criteria
Data extraction
Study quality
Internet search and consultation of experts
Results
Name tool/short description | Country | Sourcea | Specific for metastatic breast cancer | Description of tool |
---|---|---|---|---|
CONNECT | USA | S | No | A communication aid that assesses patient preferences and values, and includes communication skills training, plus summary report to the physician. |
Decision aid on first, second, third and fourth line chemotherapy | USA | S | No | State-of-the-art tables with information for patients with advanced breast, lung, colon, and hormone-refractory prostate cancers |
Decision aid on first-line chemotherapy | Australia and Canada | E, S | Yes | A DA presenting options of supportive care, with or without chemotherapy. Potential benefits and side effects of different chemotherapy regimens, and evidence-based prognostic estimates are described, and a values clarification exercise is included. |
Decision aid on second-line chemotherapy | The Netherlands | E, I, S | Yes | A DA describing the adverse events, response of the cancer and survival of supportive care with or without second-line palliative chemotherapy. |
Decision aid ‘metastatic breast cancer’ | The Netherlands | I | Yes | A booklet presenting information on therapies and supportive treatment in metastatic breast cancer. It provides information on what characteristics define how metastatic breast cancer can be treated and shows other patients arguments for and against treatment. |
Consultation guide | The Netherlands | E | No | A booklet with sample questions and an instrument for value clarification. |
Living with Metastatic Breast Cancer: Making the Journey Your Own. | USA | S | Yes | A thirty-minute video/DVD and accompanying booklet depicting the experiences of 4 women living with metastatic breast cancer. |
Name tool/short description | First author (year) | Study populationa | Design | Decision aid outcome measures | Outcome | GRADE |
---|---|---|---|---|---|---|
CONNECT | Meropol (2013) | Metastatic cancer patients, n = 629 (F:48%), mean age: 59 year | Randomized clinical trial with 3 arms | Consultation content, treatment outcome expectations, decisional conflict, patient satisfaction with the content and format of the communication, and satisfaction with the survey and/or communication skills training | • Treatment decisions were easier to reach (P = 0.003) • Patients were more satisfied with decisions (P < 0.001) • Patients were more satisfied with physician communication (P = 0.026) • Patients were more satisfied with discussion regarding support services (P = 0.029) and quality of life concerns (P = 0.042) • No statistically significant differences in satisfaction regarding discussion of diagnosis/prognosis, treatment options, or support/community services. | Low |
Decision aid on first, second, third and fourth line chemotherapy | Smith (2011) | Patients with metastatic breast, colorectal or lung cancer, n = 27 (F:56%), mean age: 63 year | Pilot pretest, posttest study | Number of patients who opt for full disclosure once they viewed the DA The amount of information patients have about cure, response rates, and symptom control; the impact of truthful information on hope, whether the information was deemed helpful to the patient; and whether the patient want to share the information with a physician | • 96% of the patients chose to complete the DA • The proportion of patients who thought that advanced cancer could be cured reduced from 52 to 31% (P = 0.15) • 87% of the patients overestimated the effect of palliative chemotherapy • No distress was noted and hope did not change • 74% found the information helpful • 93% wanted to share the information with their family and physician | Very low |
Decision aid on first-line chemotherapy | Chiew (2008) | Metastatic breast cancer patients, n = 17 (F:100%), median age: 58 year Medical oncologists, n = 7 | Pilot observational study | Patients’ attitudes toward the DA, and oncologist feedback regarding attitudes toward the DA. | • The DA was rated acceptable and helpful. • The DA contains an appropriate amount of information, and the length is appropriate • 94% of the patients would recommend use of the DA to others • Oncologists received the DA positively and found it appropriate for all or most patients | Very low |
Decision aid on second-line chemotherapy | Oostendorp (2017) | Patients with metastatic breast or colorectal cancer, n = 128 (F:63%), median age: 62 year | Randomized clinical trial | Anxiety, depression, general health, cancer worries, health-related quality of life, coping styles, amount of information received, satisfaction with quality of information, subjective knowledge, treatment preference, decision satisfaction and uncertainty, decision control and treatment attitudes. | • The DA had no adverse impact on patient’s well-being • Use of the DA was associated with stronger treatment preferences (P = 0.030) and increased subjective knowledge (P = 0.022) • No statistically significant differences in anxiety, depression, general health, cancer worries, health-related quality of life, coping styles, amount of information received, satisfaction with quality of information, decision satisfaction and uncertainty, decision control and treatment attitudes. | Moderate |
Living with Metastatic Breast Cancer: Making the Journey Your Own | Sepucha (2009) | Metastatic breast cancer patients, n = 32 (F:100%), median age: 55 year | Pilot pretest, posttest study | Use and acceptability of DA, distress, treatment goals, and preference for and actual participation in decision | • The DA was rated acceptable and did not increase distress (P = 0.34) • Most patients (88%) desired to share decision making with their physician • 41% of the patients found that decision making was shared • 38% achieved their desired level of participation • The main goal of treatment was most often to lengthen life | Very low |