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The Influence of Non-Clinical Patient Factors on Medical Oncologists’ Decisions to Recommend Breast Cancer Adjuvant Chemotherapy
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Jun 21 2012
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Source: Breast Cancer Res Treat. 134(2):867-874.
[PDF-562.72 KB]
Details:
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Alternative Title:Breast Cancer Res Treat
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Description:BACKGROUND
The extent to which medical oncologists consider non-clinical patient factors when deciding to recommend adjuvant chemotherapy is unknown.
METHODS
Medical oncologists who treated a population-based sample of early-stage breast cancer patients reported to the Los Angeles and Detroit Surveillance, Epidemiology, and End Results registries 2005–2007 were asked how strongly they consider a patient’s ability to follow instructions, level of social support, and level of work support/flexibility in decisions to recommend adjuvant chemotherapy. Responses of 4 (Quite strongly) or 5 (Very strongly) on a 5-point Likert scale defined strong consideration. Associations between oncologist/practice characteristics and strong consideration of each non-clinical factor were examined.
RESULTS
134 oncologists (66%) reported strong consideration of one or more factor. Ability to follow instructions was strongly considered by 120 oncologists (59%), social support by 78 (38%), and work support/flexibility by 73 (36%). Larger percent of practice devoted to breast cancer was associated with lower likelihood of strongly considering ability to follow instructions [odds ratio (OR) 0.98, 95% confidence interval (CI) 0.97–0.99; P=0.04]. Increased years in practice was associated with lower likelihood of strongly considering social support (OR 0.96, CI 0.93–0.99; P=0.011), while non-white race (OR 2.1, CI 1.03–4.26; P=0.041) and tumor board access (OR 2.04, CI 1.01–4.12; P=0.048) were associated with higher likelihood. Non-white race was associated with strongly considering work support/flexibility (OR 2.44, CI 1.21–4.92; P=0.013). Tumor board access (OR 2, CI 1.00–4.02; P=0.051) was borderline significant.
CONCLUSIONS
Non-clinical patient factors play a role in medical oncologist decision-making for breast cancer adjuvant chemotherapy recommendations.
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Pubmed ID:22718307
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Pubmed Central ID:PMC5513505
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Volume:134
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Issue:2
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