TY - JOUR
T1 - The choice dilemma in chronic hematological conditions
T2 - Why choosing is not only a medical issue? A psycho-cognitive perspective
AU - Renzi, Chiara
AU - Riva, Silvia
AU - Masiero, Marianna
AU - Pravettoni, Gabriella
PY - 2016/3/1
Y1 - 2016/3/1
N2 - Research in cognitive psychology focused on risk perception and decision making was shown to facilitate treatment choice and patient's satisfaction with decision in a number of medical conditions, increasing perceived alliance between patient and physician, and adherence to treatment. However, this aspect has been mostly neglected in the literature investigating choice of treatment for chronic hematological conditions. In this paper, a patient centered model and a shared decision making (SDM) approach to treatment switch in chronic hematological conditions, in particular chronic myeloid leukemia, atrial fibrillation, and β-thalassemia is proposed. These pathologies have a series of implications requiring important decisions about new available treatments. Although new generation treatmentsmay provide a significant improvement in patient's health and health-related quality of life (HrQoL), a significant percentage of them is uncertain about or refuse treatment switch, even when strongly suggested by healthcare guidelines. Possible cognitive and emotional factors which may influence decision making in this field and may prevent appropriate risk-and-benefits evaluation of new treatment approaches are reviewed. Possible adaptive strategies to improve quality of care, patient participation, adherence to treatment and final satisfaction are proposed, and implications relatively to new treatment options available are discussed.
AB - Research in cognitive psychology focused on risk perception and decision making was shown to facilitate treatment choice and patient's satisfaction with decision in a number of medical conditions, increasing perceived alliance between patient and physician, and adherence to treatment. However, this aspect has been mostly neglected in the literature investigating choice of treatment for chronic hematological conditions. In this paper, a patient centered model and a shared decision making (SDM) approach to treatment switch in chronic hematological conditions, in particular chronic myeloid leukemia, atrial fibrillation, and β-thalassemia is proposed. These pathologies have a series of implications requiring important decisions about new available treatments. Although new generation treatmentsmay provide a significant improvement in patient's health and health-related quality of life (HrQoL), a significant percentage of them is uncertain about or refuse treatment switch, even when strongly suggested by healthcare guidelines. Possible cognitive and emotional factors which may influence decision making in this field and may prevent appropriate risk-and-benefits evaluation of new treatment approaches are reviewed. Possible adaptive strategies to improve quality of care, patient participation, adherence to treatment and final satisfaction are proposed, and implications relatively to new treatment options available are discussed.
KW - Atrial fibrillation
KW - Chronic myeloid leukemia
KW - Decision making
KW - Patients' decision
KW - Treatment switch
KW - β-Thalassemia
UR - http://www.scopus.com/inward/record.url?scp=84959472030&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84959472030&partnerID=8YFLogxK
U2 - 10.1016/j.critrevonc.2015.12.010
DO - 10.1016/j.critrevonc.2015.12.010
M3 - Article
AN - SCOPUS:84959472030
VL - 99
SP - 134
EP - 140
JO - Critical Reviews in Oncology/Hematology
JF - Critical Reviews in Oncology/Hematology
SN - 1040-8428
ER -