Journal article
Discrepancy between treatment goals documentation by oncologists and their understanding among cancer patients under active treatment with chemotherapy
European journal of cancer care, Vol.28(2), pp.e12973-n/a
03/2019
DOI: 10.1111/ecc.12973
PMCID: PMC6416062
PMID: 30511450
Abstract
Discussion of treatment goals between oncologists and patients is challenging. Patients frequently misunderstand goals of therapy. There are several methods to document goals of chemotherapy, however, and are frequently not incorporated into patient charts.
Cancer patients receiving their first cycle of chemotherapy were interviewed. Patients' recall of discussions with their oncologist regarding therapy intent was assessed and compared to documentation. An adjusted McNemar's test was utilised. A one-sample proportion test was used to evaluate whether the overall observed rate of discordance was significantly different from the proposed 33% rate; a rate posited as a threshold too high in the clinical sense.
Two hundred and seven eligible patients were interviewed. Oncologist identified treatment goals were not documented in 24.6% of cases and had to be excluded. There was not a significant difference in the directionality of discordance present. Inter-rater agreement between patient and oncologist was found to be adequate (κ = 0.64). The overall rate of discordance (17.29%) was found to be significantly less than the proposed acceptable level of 33% (p < 0.01). Upon univariable analysis, age, gender, marital and employment status were not found to be associated with discordance.
Discordance between treatment goals documentation and their understanding exists, indicating continued miscommunication between the patient and oncologist.
Details
- Title: Subtitle
- Discrepancy between treatment goals documentation by oncologists and their understanding among cancer patients under active treatment with chemotherapy
- Creators
- Varun Monga - Division of Hematology, Oncology, and Blood and Marrow Transplantation, University of Iowa Carver College of Medicine, Iowa City, IowaSeth M Maliske - Aspirus Wausau Hospital Regional Cancer Center, Wausau, WisconsinHassan Kaleem - Division of Hematology and Oncology, Texas Tech University, Lubbock, TexasSarah L Mott - Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IowaGideon K D Zamba - Department of Biostatistics, University of Iowa, Iowa City, IowaMohammed Milhem - Division of Hematology, Oncology, and Blood and Marrow Transplantation, University of Iowa Carver College of Medicine, Iowa City, Iowa
- Resource Type
- Journal article
- Publication Details
- European journal of cancer care, Vol.28(2), pp.e12973-n/a
- DOI
- 10.1111/ecc.12973
- PMID
- 30511450
- PMCID
- PMC6416062
- NLM abbreviation
- Eur J Cancer Care (Engl)
- ISSN
- 0961-5423
- eISSN
- 1365-2354
- Publisher
- England
- Grant note
- NIH U54TR001013 / CTSA U54 TR001013 / NCATS NIH HHS P30 CA086862 / NCI NIH HHS
- Language
- English
- Date published
- 03/2019
- Academic Unit
- Radiology; Biostatistics; Orthopedics and Rehabilitation; Internal Medicine
- Record Identifier
- 9983997309902771
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