Accuracy of physician assessment of treatment preferences and health status in elderly patients with higher-risk myelodysplastic syndromes

G. Caocci, M. T. Voso, E. Angelucci, R. Stauder, F. Cottone, G. Abel, K. Nguyen, U. Platzbecker, O. Beyne-Rauzy, G. Gaidano, R. Invernizzi, S. Molica, M. Criscuolo, M. Breccia, M. Lübbert, G. Sanpaolo, F. Buccisano, A. Ricco, G. A. Palumbo, P. NiscolaH. Zhang, S. Fenu, G. La Nasa, F. Mandelli, F. Efficace

Research output: Contribution to journalArticlepeer-review

Abstract

Higher-risk myelodysplastic syndromes (MDS) are rarely curable and have a poor prognosis. We investigated the accuracy of physicians' perception of patients' health status and the patients' preferences for involvement in treatment decisions.We examined 280 newly diagnosed higher-risk elderly MDS patients paired with their physicians. Survey tools included the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) and the Control Preference Scale.Overall concordance was 49% for physician perception of patient preferences for involvement in treatment decisions. In 36.4% of comparisons there were minor differences and in 14.6% there were major differences. In 44.7% of the patients preferring a passive role, physicians perceived them as preferring an active or collaborative role. Absence of the patient's request for prognostic information ( P = 0.001) and judging the patient as having a poor health status ( P = 0.036) were factors independently associated with the physicians' attitude toward a lower degree of patient involvement in clinical decisions. Agreement on health status was found in 27.5% of cases. Physicians most frequently tended to overestimate health status of patients who reported low-level health status.The value of decision aid-tools in the challenging setting of higher-risk MDS should be investigated to further promote patient-centered care.

Original languageEnglish
Pages (from-to)859-865
Number of pages7
JournalLeukemia Research
Volume39
Issue number8
DOIs
Publication statusPublished - Aug 1 2015

Keywords

  • Cancer
  • Decision making
  • Health status
  • Hematology
  • Myelodysplastic syndromes
  • Oncology

ASJC Scopus subject areas

  • Cancer Research
  • Hematology
  • Oncology

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