Journal
LEUKEMIA RESEARCH
Volume 39, Issue 8, Pages 859-865Publisher
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.leukres.2015.05.012
Keywords
Health status; Decision making; Myelodysplastic syndromes; Cancer; Oncology; Hematology
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Funding
- Associazione Italiana contro le Leucemie, Linfomi e Mieloma (AIL)
- Italian Group for Adult Hematologic Diseases (GIMEMA)
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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 anactive 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 healthstatus 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. (C) 2015 Elsevier Ltd. All rights reserved.
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