Published on November 30th 2018 – Treatment decision making for older patients is a complex communication process in which specialists from different disciplines are involved. Sifra Bolle investigated if patient characteristics are considered in this communication process.
Non-participant observations of 171 older patients (≥70 years) with cancer were conducted during 30 multidisciplinary team meetings in five hospitals. The authors observed the decision making process during these meeting. They also observed the extent to which geriatric evaluation of age-related characteristics and participation of geriatric expertise contributed to the decision making process.
The authors found that discussion of alternative treatment options and arguments in favor of or against treatment options were often not part of the decision-making process. Second, they found that information on age-related patient characteristics and patient preferences was often left out of the discussion. Finally, there were only few remarks during the meeting suggesting geriatric evaluation. Moreover, the contribution of geriatric experts to the discussion was limited.
The results of this study show that there is a need for structured communication and a stronger role of geriatrics experts during multidisciplinary team meetings. Moreover, only by taking patients’ individual wishes and vulnerabilities into account, care for older patients with cancer may become truly patient-centered.
This study was funded by the Amsterdam School of Communication Research (ASCoR) and the Dutch Cancer Society (KWF).
Read more? Bolle S, Smets EMA, Hamaker ME, Loos EF, van Weert JCM (in press). Medical decision making for older patients during multidisciplinary oncology team meetings. J Geriatr Oncol 2018.
The article can be found here.