You are in PORTALS Digital Radiography Shared Decision Making During Radiation Therapy TreatmentImproves Patient Satisfaction

Shared Decision Making During Radiation Therapy TreatmentImproves Patient Satisfaction

E-mail Print PDF



Based on a recent study by researchers from the Perelman School of Medicine at the University of Pennsylvania, playing an active role in their radiation treatment decisions puts cancer patients at ease and has them feeling more satisfied with their care, and may even alleviate psychological distress around the circumstance.


In the study, which was published in the journal Cancer, 305 patients receiving radiation treatment, Neha Vapiwala, MD, an associate professor in the department in Radiation Oncology at Penn Medicine, and colleagues at Penn's Abramson Cancer Center discovered a connection between patient satisfaction and patient-perceived control and shared decision making (SDM), the process that enables patients and providers to make health care decisions together, taking into account scientific evidence as well as the patient's values and preferences.


Patients who experienced SDM or perceived some control over their treatments were more satisfied with their care as opposed to those who did not experience SDM or perception of control, a difference of almost 17 percent and 26 percent, respectively. Additionally, increased anxiety, depression and fatigue were reported in patients who desired control over treatments, but did not distinguish this control.


"Most importantly, our findings emphasize the value of patient-physician relationships and communication specifically in radiation oncology, and their impact on patient experience in a way that hasn't been shown before. No matter where cancer patients are in the treatment process, there is always an opportunity to improve patient satisfaction, something hospitals and providers have consciously and increasingly been making a priority," said Vapiwala.


Previous studies of SDM in patients receiving chemotherapy, as well as treatments for other medical conditions such ashypertension and diabetes, have demonstrated a correlation with improved satisfaction and quality of life. Taking into account, the Institute of Medicine recently recognized its importance, and theAffordable Care Act even devotes a whole section to establishing a program for SDM. Though, no group has assessed its impact on patients going through radiation.

Frequently, radiation oncology is viewed as a treatment specialty that is ultimately left up to the physician to determine the course of action. However, there are tailored options, decisions, and discussions that can apply to individual patients, even if they all have similar diagnoses. There are varying radiation regimens, dosages, risks and benefits, as well as pain control managementissues, that should be part of the ongoing conversation.

Amongst the patients enrolled in the study, 31 percent of patients experienced SDM, 32 percent perceived control in decisions, and 76 percent reported feeling very satisfied with their radiation treatment course overall. There was a prominent link between patient satisfaction with his/her radiation treatments and patient-perceived experience of SDM (84.4 percent vs. 71.4 percent) or perceived control over one's treatment (89.7 percent vs. 69.2 percent).

Patients who particularly desired control over their treatment decisions, but did not perceive this control, experienced a higher rate of anxiety (44 percent vs. 20 percent), depression (44 percent vs. 15 percent), and fatigue (68 percent vs. 39.2 percent), as opposed to patients who did not perceive a sense of control in their treatment decisions.

One of the advantages of the study is its assorted group of patients. Ages ranged from 18 to 87 years old, with patients of varying ethnic and racial backgrounds, and having diverse cancers at all stages, as long as they were well enough to participate in the study.

The next phase in the research is to determine both physician and patient barriers to SDM and to determine methods and techniques to break down such barriers.

"As providers, it doesn't matter what treatment you are offering, or how complicated it is, or how busy you may be. It’s worth taking even a few minutes to talk to patients about seemingly minor decisions in which they can provide some input. It's not only critical in today's health care setting where both information and misinformation are rampant, but will very likely lead to the patient feeling positively about the encounter," said Vapiwala.

These signals are relayed buying clomid online safe which then is by a number of such as medial preoptic and paraventricular nulcei.