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Prioritisation of treatment goals among older patients with non-curable cancer: the OPTion randomised controlled trial in Dutch primary care

Stegmann, M. E., Brandenbarg, D., Reyners, A. K., van Geffen, W. H., Hiltermann, T. J. N. & Berendsen, A. J., Jul-2020, In : British Journal of General Practice. 70, 696, p. E450-E456 7 p., bjgp20X710405.

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DOI

Background

Older patients with cancer often find it difficult to take part in shared decision making.

Aim

To assess the utility of the Outcome Prioritisation fool (OPT). designed to aid discussion with a patient in regards to their treatment goals, to empower patients with cancer through structured conversations about generic treatment goals with GPs.

Design and setting

A randomized controlled trial of 114 Dutch participants recruited between November 2015 and January 2019, aged >= 60 years with non curable cancer who had to make a treatment decision with an oncologist. The intervention group used the OPT while the control group received care as usual.

Method

The primary outcome was patient empowerment using the score on the decision self-efficacy (DSE) scale. Secondary outcomes were symptoms measures of fatigue, anxiety. and depression. The experiences of participants were also explored.

Results

No effect was found on patient empowerment between the OPI group to - 48; DSE 86.8; standard deviation [SD] = 18.2)and the control group (n = 58; DSE 84.2; SD = 17.6; P. 0.47). In the OPT group, although statistically nonsignificant, fewer - patients had low empowerment (18.8%, n = 9 versus 24.1%, n- 14; P = 0.50). but they did have statistically significant lower mean anxiety scores (6.0. SD = 4.6 versus 7.6, SD = 4.4; P

Conclusion

An OPT-facilitated conversation about generic treatment goals between patients and their GPs is associated with less anxiety and fatigue, but did not show statistically significant improvements in patient empowerment. Adding the OPT to routine Giro might mitre more patient-tailored care.

Original languageEnglish
Article numberbjgp20X710405
Pages (from-to)E450-E456
Number of pages7
JournalBritish Journal of General Practice
Volume70
Issue number696
Early online date1-Jun-2020
Publication statusPublished - Jul-2020

    Keywords

  • aged, decision making, general practice, neoplasms, palliative care, primary health care, DECISION-MAKING, OUTCOME PRIORITIZATION, SELF-EFFICACY, FATIGUE, PREFERENCES, CRITERIA, MFI-20

ID: 126529931