Implementation, participation and satisfaction rates of a web-based decision support tool for patients with metastatic colorectal cancer

Lotte Keikes; Judith de Vos-Geelen; Jan Willem B de Groot; Cornelis J A Punt; Lieke H J Simkens; Marija Trajkovic-Vidakovic; Johanneke E A Portielje; Allert H Vos; Laurens V Beerepoot; Cornelis B Hunting; Miriam Koopman; Martijn G H van Oijen

doi:10.1016/j.pec.2019.02.020

Implementation, participation and satisfaction rates of a web-based decision support tool for patients with metastatic colorectal cancer

Patient Educ Couns. 2019 Jul;102(7):1331-1335. doi: 10.1016/j.pec.2019.02.020. Epub 2019 Feb 22.

Affiliations

¹ Department of Medical Oncology, Amsterdam University Medical Centers, Location AMC, Cancer Center Amsterdam, Amsterdam, the Netherlands. Electronic address: [email protected].
² Department of Internal Medicine, Division of Medical Oncology, GROW - School for Oncology and Developmental Biology, Maastricht UMC+, Maastricht, the Netherlands. Electronic address: [email protected].
³ Department of Medical Oncology, Isala, Zwolle, the Netherlands. Electronic address: [email protected].
⁴ Department of Medical Oncology, Amsterdam University Medical Centers, Location AMC, Cancer Center Amsterdam, Amsterdam, the Netherlands. Electronic address: [email protected].
⁵ Department of Medical Oncology, Maxima Medical Center, Veldhoven, the Netherlands. Electronic address: [email protected].
⁶ Department of Medical Oncology, Albert Schweitzer Hospital, Dordrecht, the Netherlands. Electronic address: [email protected].
⁷ Department of Medical Oncology, Haga Hospital, The Hague, the Netherlands. Electronic address: [email protected].
⁸ Department of Medical Oncology, Hospital Bernhoven, Uden, the Netherlands. Electronic address: [email protected].
⁹ Department of Medical Oncology, Elisabeth-Tweesteden Hospital, Tilburg, the Netherlands. Electronic address: [email protected].
¹⁰ Department of Medical Oncology, Antonius Hospital, Nieuwegein, the Netherlands. Electronic address: [email protected].
¹¹ Department of Medical Oncology, University Medical Center, Utrecht, the Netherlands. Electronic address: [email protected].
¹² Department of Medical Oncology, Amsterdam University Medical Centers, Location AMC, Cancer Center Amsterdam, Amsterdam, the Netherlands. Electronic address: [email protected].

PMID: 30852117
DOI: 10.1016/j.pec.2019.02.020

Abstract

Objective: To examine implementation and patients' and providers' participation and satisfaction of a newly developed decision support tool (DST) for patients with metastatic colorectal cancer (mCRC) in palliative setting.

Methods: Our DST consisted of a consultation sheet and web-based tailored information for mCRC treatment options. We conducted an implementation trajectory in 11 Dutch hospitals and evaluated implementation, participation and satisfaction rates.

Results: Implementation rates fluctuated between 3 and 72 handed out (median:23) consultation sheets per hospital with patients' login rates between 36% and 83% (median:57%). The majority of patients (68%) had (intermediate)-high participation scores. The median time spent using the DST was 38 min (IQR:18-56) and was highest for questions concerning patients' perspective (5 min). Seventy-six% of patients were (very) satisfied. The provider DST rating was 7.8 (scale 1-10) and participation ranged between 25 and 100%. Remaining implementation thresholds included providers' treatment preferences, resistance against shared decision-making and (over)confidence in shared decision-making concepts already in use.

Conclusion: We implemented a DST with sufficient patient and oncologist satisfaction and high patient participation, but participation differed considerably between hospitals suggesting unequal adoption of our tool.

Practice implications: Requirements for structural implementation are to overcome remaining thresholds and increase awareness for additional decision support.

Keywords: Decision support tool; Metastatic colorectal cancer; Patient values; Shared decision-making; Treatment preferences.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Colorectal Neoplasms / therapy*
Decision Support Techniques*
Female
Humans
Internet*
Male
Middle Aged
Neoplasm Metastasis
Netherlands
Palliative Care*
Patient Satisfaction*