Primary Care Provider-Reported Involvement in Breast Cancer Treatment Decisions

Details

• Alternative Title:
  Cancer
• Personal Author:
  Wallner, Lauren P. ; Li, Yun ; McLeod, M. Chandler ; Gargaro, Joan ; Kurian, Allison W. ; Jagsi, Reshma ; Radhakrishnan, Archana ; Hamilton, Ann S. ; Ward, Kevin C. ; Hawley, Sarah T. ; Katz, Steven J.
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• Description:
  Background: ; Treatment decisions for early-stage breast cancer patients often involve discussions with multiple oncology providers. However, the extent to which primary care providers (PCPs) are involved in initial treatment decisions remains unknown. ; Methods: ; A stratified random sample of PCPs identified by newly diagnosed early-stage breast cancer patients from the Georgia and Los Angeles SEER registries were surveyed (N=517, 61% response rate). PCPs were asked how frequently they discussed surgery, radiation and chemotherapy options with patients, how comfortable they were with these discussions, whether they had the necessary knowledge to participate in decision-making, and their confidence in their ability to help (5-item Likert-type scales). Multivariable logistic regression was used to identify PCP-reported attitudes associated with more PCP participation in each treatment decision. ; Results: ; In this sample, 34% of PCPs reported that they discussed surgery, 23% discussed radiation, and 22% discussed chemotherapy options with their patients. Of those who reported more involvement in surgical decisions, 22% reported they were not comfortable having a discussion, and 17% did not feel they had the necessary knowledge to participate in treatment decision-making. PCPs who positively appraised their ability to participate were more likely to participate in all three decisions (Surgery OR: 6.01, 95%CI: 4.16–8.68; Radiation OR: 8.37, 95%CI: 5.16–13.58; Chemotherapy OR: 6.56, 95%CI: 4.23–10.17). ; Conclusions: ; A third of PCPs reported participating in breast cancer treatment decisions, yet gaps in knowledge about decision making and confidence in their ability to help exist. Efforts to increase PCP knowledge about breast cancer treatment options may be warranted.
• Keywords:
  • primary care provider
  • cancer care
  • cancer treatment decisions
  • treatment decision making
  • breast cancer
  • Adult
  • Aged
  • Breast Neoplasms
  • Clinical Competence
  • Clinical Decision-Making
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• Source:
  Cancer. 125(11):1815-1822
• Pubmed ID:
  30707773
• Pubmed Central ID:
  PMC6509002
• Document Type:
  Journal Article
• Funding:
  HHSN261201000140C/CA/NCI NIH HHSUnited States/ ; HHSN261201000035C/CA/NCI NIH HHSUnited States/ ; P30 CA046592/CA/NCI NIH HHSUnited States/ ; HHSN261201000035I/CA/NCI NIH HHSUnited States/ ; HHSN261201300015C/CA/NCI NIH HHSUnited States/ ; HHSN261201000034C/CA/NCI NIH HHSUnited States/ ; U58 DP003862/DP/NCCDPHP CDC HHSUnited States/ ; K07 CA201052/CA/NCI NIH HHSUnited States/ ; P01 CA163233/CA/NCI NIH HHSUnited States/ ; U58 DP003875/DP/NCCDPHP CDC HHSUnited States/
• Volume:
  125
• Issue:
  11
• Download URL:
  https://stacks.cdc.gov/view/cdc/78401/cdc_78401_DS1.pdf
• File Type:
  [PDF - 843.15 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:1b89a6c50f685a5e120fa18d33ab794e15592d15439fbdea3a9d82051049070a