Improving sustainability of a patient decision aid for systemic treatment of metastatic colorectal cancer: A qualitative study.
Sietske C M W van Nassau, Helene R Voogdt-Pruis, Vincent M W de Jong, Hans-Martin Otten, Liselot B Valkenburg-van Iersel, Bas J Swarte, Tineke E Buffart, Hans J Pruijt, Leonie J Mekenkamp, Miriam Koopman, Anne M May
Author Information
Sietske C M W van Nassau: Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
Helene R Voogdt-Pruis: Department of Global Public Health and Bioethics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
Vincent M W de Jong: Dutch patient federation for colorectal cancer (Stichting Darmkanker), Utrecht, the Netherlands.
Hans-Martin Otten: Department of Medical Oncology, Meander Medical Center Amersfoort, Amersfoort, the Netherlands.
Liselot B Valkenburg-van Iersel: Division of Medical Oncology, Department of Internal Medicine, Maastricht University Medical Center, GROW-School for Oncology and Developmental Biology, Maastricht, the Netherlands.
Bas J Swarte: Department of Medical Oncology, Maasstad Ziekenhuis, Rotterdam, the Netherlands.
Tineke E Buffart: Department of Medical Oncology, Amsterdam University Medical Centers, location VUMC, Amsterdam, the Netherlands.
Hans J Pruijt: Department of Medical Oncology, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands.
Leonie J Mekenkamp: Department of Medical Oncology, Medisch Spectrum Twente, Enschede, the Netherlands.
Miriam Koopman: Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
Anne M May: Department of Epidemiology and Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
Objective: To improve sustainability of a patient decision aid for systemic treatment of metastatic colorectal cancer, we evaluated real-world experiences and identified ways to optimize decision aid content and future implementation. Methods: Semi-structured interviews with patients and medical oncologists addressed two main subjects: user experience and decision aid content. Content analysis was applied. Fifteen experts discussed the results and devised improvements based on experience and literature review. Results: Thirteen users were interviewed. They confirmed the relevance of the decision aid for shared decision making. Areas for improvement of content concerned; 1) outdated and missing information, 2) an imbalance in presentation of treatment benefits and harms, and 3) medical oncologists' expressed preference for a more center-specific or patient individualized decision aid, presenting a selection of the guideline recommended treatment options. Key points for improvement of implementation were better alignment within the care pathway, and clear instruction to users. Conclusion: We identified relevant opportunities for improvement of an existing decision aid and developed an updated version and accompanying implementation strategy accordingly. Innovation: This paper outlines an approach for continued decision aid and implementation strategy development which will add to sustainability. Implementation success of the improved decision aid is currently being studied in a multi-center mixed-methods implementation study.
