Effects of a Computerized System to Support Shared Decision Making in Symptom Management of Cancer Patients: Preliminary Results

Overview

Journal J Am Med Inform Assoc

Publisher Oxford University Press

Specialty Medical Informatics

Date 2003 Aug 20

PMID 12925545

Citations 45

Authors

Cornelia M Ruland

Thomas White

Marguerite Stevens

Gilbert Fanciullo

Samir M Khilani

Affiliations

Soon will be listed here.

Abstract

Objective: (1) To evaluate preliminary effects of a computerized support system on congruence between patients' reported symptoms and preferences and those addressed in the patient consultation and (2) to investigate the system's ease of use, time requirements, and patient satisfaction.

Design: Fifty-two patients were randomly assigned to intervention or control conditions.

Measurements: Cancer patients scheduled for an outpatient visit used the system on a tablet computer to report their symptoms and preferences prior to their consultation. This information was processed, printed, and provided to the patient and clinician in the subsequent consultation in the experimental group but not in the control group.

Results: While patients in both groups were equivalent at baseline in symptom characteristics, there was significantly greater congruence between patients' reported symptoms and those addressed by their clinicians in the experimental group. The system scored high on ease of use. There were no significant group differences in patient satisfaction.

Conclusion: This study provided beginning evidence that eliciting patients' symptoms and preferences and providing clinicians with this information prior to consultation can be an effective and feasible strategy to improve patient-centered care.

Citing Articles

Cancer Patients' Perspectives and Requirements of Digital Health Technologies: A Scoping Literature Review.

Lazarou I, Krooupa A, Nikolopoulos S, Apostolidis L, Sarris N, Papadopoulos S Cancers (Basel). 2024; 16(13).

PMID: 39001356 PMC: 11240750. DOI: 10.3390/cancers16132293.

Factors Involved in Shared Decision-making Regarding Treatment Selection by Patients With Cancer.

Kawasaki Y, Hirai K, Nii M, Kizawa Y, Uchinuno A Cancer Diagn Progn. 2024; 4(1):57-65.

PMID: 38173669 PMC: 10758844. DOI: 10.21873/cdp.10286.

Feasibility and User Experience of Digital Patient Monitoring for Real-World Patients With Lung or Breast Cancer.

Arriola E, Jaal J, Edvardsen A, Silvoniemi M, Araujo A, Vikstrom A Oncologist. 2023; 29(4):e561-e569.

PMID: 38007400 PMC: 10994260. DOI: 10.1093/oncolo/oyad289.

Effectiveness of routine provision of feedback from patient-reported outcome measurements for cancer care improvement: a systematic review and meta-analysis.

Lu S, Porter I, Valderas J, Harrison C, Sidey-Gibbons C J Patient Rep Outcomes. 2023; 7(1):54.

PMID: 37277575 PMC: 10241766. DOI: 10.1186/s41687-023-00578-8.

Patient focused interventions and communication in the surgical clinic: a systematic review and meta-analysis.

Herath M, Reid J, Ting Y, Bradshaw E, Edwards S, Bruening M EClinicalMedicine. 2023; 57:101893.

PMID: 36942159 PMC: 10024183. DOI: 10.1016/j.eclinm.2023.101893.

References

Holmes-Rovner M, Valade D, Orlowski C, Draus C, Keiser S . Implementing shared decision-making in routine practice: barriers and opportunities. Health Expect. 2001; 3(3):182-191. PMC: 5080967. DOI: 10.1046/j.1369-6513.2000.00093.x. View

Lenert L, Sturley A . Use of the internet to study the utility values of the public. Proc AMIA Symp. 2002; :440-4. PMC: 2244417. View

Lenert . iMPACT3: online tools for development of web sites for the study of Patients' preferences and utilities. Proc AMIA Symp. 2000; :1172. PMC: 2243909. View

Lewis J . Patient views on quality care in general practice: literature review. Soc Sci Med. 1994; 39(5):655-70. DOI: 10.1016/0277-9536(94)90022-1. View

Goldstein M, Clarke A, Michelson D, Garber A, Bergen M, Lenert L . Developing and testing a multimedia presentation of a health-state description. Med Decis Making. 1994; 14(4):336-44. DOI: 10.1177/0272989X9401400404. View

Lenert L, Soetikno R . Automated computer interviews to elicit utilities: potential applications in the treatment of deep venous thrombosis. J Am Med Inform Assoc. 1997; 4(1):49-56. PMC: 61198. DOI: 10.1136/jamia.1997.0040049. View

Gustafson D, Hawkins R, Pingree S, McTavish F, Arora N, Mendenhall J . Effect of computer support on younger women with breast cancer. J Gen Intern Med. 2001; 16(7):435-45. PMC: 1495237. DOI: 10.1046/j.1525-1497.2001.016007435.x. View

Molenaar S, Sprangers M, Rutgers E, Noorlander J, Hendriks J, de Haes H . Feasibility and effects of decision aids. Med Decis Making. 2000; 20(1):112-27. DOI: 10.1177/0272989X0002000114. View

OConnor A, Tugwell P, Wells G, Elmslie T, Jolly E, Hollingworth G . Randomized trial of a portable, self-administered decision aid for postmenopausal women considering long-term preventive hormone therapy. Med Decis Making. 1998; 18(3):295-303. DOI: 10.1177/0272989X9801800307. View

10.

Ruland C . Handheld technology to improve patient care: evaluating a support system for preference-based care planning at the bedside. J Am Med Inform Assoc. 2002; 9(2):192-201. PMC: 344576. DOI: 10.1197/jamia.m0891. View

11.

OConnor A, Rostom A, Fiset V, Tetroe J, Entwistle V, Llewellyn-Thomas H . Decision aids for patients facing health treatment or screening decisions: systematic review. BMJ. 1999; 319(7212):731-4. PMC: 28223. DOI: 10.1136/bmj.319.7212.731. View

12.

Gustafson D, Hawkins R, Boberg E, McTavish F, Owens B, Wise M . CHESS: ten years of research and development in consumer health informatics for broad populations, including the underserved. Stud Health Technol Inform. 2001; 84(Pt 2):1459-563. View

13.

OConnor A, Drake E, Fiset V, Graham I, Laupacis A, Tugwell P . The Ottawa patient decision aids. Eff Clin Pract. 1999; 2(4):163-70. View

14.

Morgan M, Deber R, Llewellyn-Thomas H, Gladstone P, Cusimano R, ORourke K . Randomized, controlled trial of an interactive videodisc decision aid for patients with ischemic heart disease. J Gen Intern Med. 2000; 15(10):685-93. PMC: 1495608. DOI: 10.1046/j.1525-1497.2000.91139.x. View

15.

Ruland C . Decision support for patient preference-based care planning: effects on nursing care and patient outcomes. J Am Med Inform Assoc. 1999; 6(4):304-12. PMC: 61371. DOI: 10.1136/jamia.1999.0060304. View

16.

White T, Hauan M . The capture and use of detailed process information in the Dialogix system for structured web-based interactions. Proc AMIA Symp. 2002; :761-5. PMC: 2243335. View

17.

Hall J, Dornan M . Meta-analysis of satisfaction with medical care: description of research domain and analysis of overall satisfaction levels. Soc Sci Med. 1988; 27(6):637-44. DOI: 10.1016/0277-9536(88)90012-3. View

18.

OConnor A, Stacey D, ROVNER D, Holmes-Rovner M, Tetroe J, Llewellyn-Thomas H . Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev. 2001; (3):CD001431. DOI: 10.1002/14651858.CD001431. View

19.

Barry M, Fowler Jr F, Mulley Jr A, Henderson Jr J, WENNBERG J . Patient reactions to a program designed to facilitate patient participation in treatment decisions for benign prostatic hyperplasia. Med Care. 1995; 33(8):771-82. DOI: 10.1097/00005650-199508000-00003. View