Providing information to prepare breast cancer patients for their surgical consultation: barriers and recommendations (an analysis from Alliance A231701CD)
Abstract
Purpose: We conducted Alliance clinical trial A231701CD that provided breast cancer patients a decision aid (DA) before their surgical consultation with the goal of improving engagement in decision-making. We report a mixed-methods analysis from patients who received the DA to understand patients' experiences in preparing for their consultation.
Methods: Patients were included in this analysis if they were randomized to the DA arm (n = 331) and agreed to receive the DA (n = 195). Data collection included surveys before and after the consultation that assessed whether patients reviewed the DA and found it helpful, and reasons for non-review. We interviewed a subset of patients who had low engagement and experienced a preparatory barrier. We used descriptive statistics to summarize survey responses and content analysis to analyze interview data.
Results: Seventy-three percent (n = 143) reviewed the DA before the consultation. The majority (93%) said they would recommend receiving information via email. The most common reasons for non-review were logistical. Additional barriers included wanting to hear information directly from the surgeon, feeling they were already informed, wanting to stay in denial about their cancer, and perceiving information would be scary. Interviewees shared suggestions for clinics to optimize patients' review of information, such as explaining how preparing benefits patients and acknowledging emotion around cancer diagnoses.
Conclusion: Our study…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 331 participants or records.
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