An interactive website improved knowledge and decision-making among patients with breast cancer, study data showed.
“Knowledge is a key component of decision-making, and yet it’s consistently low even among patients who have received treatment,” Sarah T. Hawley, PhD, MPH, professor in the division of general medicine at University of Michigan, said in a press release. “We need better tools to make these decisions more informed.”
The researchers preformed a randomized clinical trial of patients with early-stage breast cancer (n = 537), all of whom faced locoregional treatment decisions. Researchers randomly assigned the patients to use either the iCanDecide interactive, tailored website (intervention) or a static iCanDecide website (control) to aid in making choices about their treatment. Patients responded to a survey at baseline assessing their knowledge and the quality of their decision-making, defined as “values-concordant treatment,” as well as secondary outcomes including deliberation, decision preparation and subjective quality of decisions. Participants completed a follow-up survey at 4 to 5 weeks after enrollment.
Patients who used the interactive website appeared more likely to make a high-quality treatment decision than those who used the static website (OR = 2; 95% CI, 1.37-2.92). Patients in the intervention group had a greater likelihood of showing “high knowledge” (OR = 2.19; 95% CI, 1.51-3.18), which drove the improvement.
In both arms of the study, patients reported making decisions that aligned with their values (78.6% in the intervention arm vs. 81.4% in the control arm). Further, more patients assigned to the intervention arm reported high levels of decision preparation (estimate, 0.18; 95% CI, 0.02-0.34). However, the two groups did not report significant differences for other outcomes related to decision appraisal.
The intervention produced similar outcomes both for women leaning strongly toward a particular treatment option at baseline and those who were not.
“Implementation studies are needed to better determine how to deploy and evaluate such tools as iCanDecide in the context of surgeon and practice variation,” the researchers wrote. “Innovative strategies are needed to ensure that these tools can be broadly deployed to improve patient-clinician decision-making.” – by Andy Polhamus
Disclosures: Hawley reports no relevant financial disclosures. Please see the full study for a complete list of all other authors’ relevant financial disclosures.