PMID- 30679905
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220331
IS  - 1177-889X (Print)
IS  - 1177-889X (Electronic)
IS  - 1177-889X (Linking)
VI  - 13
DP  - 2019
TI  - Efficient development and usability testing of decision support interventions for 
      older women with breast cancer.
PG  - 131-143
LID - 10.2147/PPA.S178347 [doi]
AB  - BACKGROUND: Around one-third of breast cancers diagnosed every year in the UK are 
      in women aged >/=70 years. However, there are currently no decision support 
      interventions (DESIs) for older women who have a choice between primary endocrine 
      therapy and surgery followed by adjuvant endocrine therapy (surgery+endocrine 
      therapy), or who can choose whether or not to have chemotherapy following 
      surgery. There is also little evidence-based guidance specifically on the 
      management of these older patients. A large UK cohort study is currently underway 
      to address this lack of evidence and to develop two DESIs to facilitate shared 
      decision-making with older women about breast cancer treatments. Here, we present 
      the development and initial testing of these two DESIs. METHODS: An initial 
      prototype DESI was developed for the choice of primary endocrine therapy or 
      surgery+endocrine therapy. Semi-structured interviews with healthy volunteers and 
      patients explored DESI acceptability, usability, and utility. A framework 
      approach was used for analysis. A second DESI for the choice of having 
      chemotherapy or not was subsequently developed based on more focused development 
      and testing. RESULTS: Participants (n=22, aged 75-94 years, 64% healthy 
      volunteers, 36% patients) found the primary endocrine therapy /surgery+endocrine 
      therapy DESI acceptable, and contributed to improved wording and illustrations to 
      address misunderstandings. The chemotherapy DESI (tested with 14 participants, 
      aged 70-87 years, 57% healthy volunteers, 43% patients) was mostly 
      understandable, however, suggestions for rewording sections were made. Most 
      participants considered the DESIs helpful, but highlighted the importance of 
      complementary discussions with clinicians. CONCLUSION: It was possible to use a 
      template DESI to efficiently create a second prototype for a different treatment 
      option (chemotherapy). Both DESIs were acceptable and considered helpful to 
      support/augment consultations. Development of acceptable additional DESIs for 
      similar target populations using simplified methods may be an efficient way to 
      develop future DESIs. Further research is needed to test the effectiveness of the 
      DESIs.
FAU - Lifford, Kate J
AU  - Lifford KJ
AD  - Division of Population Medicine, Cardiff University, Cardiff, UK, 
      liffordkj@cardiff.ac.uk.
FAU - Edwards, Adrian
AU  - Edwards A
AD  - Division of Population Medicine, Cardiff University, Cardiff, UK, 
      liffordkj@cardiff.ac.uk.
FAU - Burton, Maria
AU  - Burton M
AD  - Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, UK.
FAU - Harder, Helena
AU  - Harder H
AD  - Sussex Health Outcomes Research and Education in Cancer, Brighton and Sussex 
      Medical School, University of Sussex, Brighton, UK.
FAU - Armitage, Fiona
AU  - Armitage F
AD  - Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK.
FAU - Morgan, Jenna L
AU  - Morgan JL
AD  - Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK.
FAU - Caldon, Lisa
AU  - Caldon L
AD  - Department of General Surgery, The Rotherham NHS Foundation Trust, Rotherham, UK.
FAU - Balachandran, Kirsty
AU  - Balachandran K
AD  - Department of Medical Oncology, Imperial College London, London, UK.
FAU - Ring, Alistair
AU  - Ring A
AD  - Breast Unit, Royal Marsden Hospital NHS Foundation Trust, Sutton, UK.
FAU - Collins, Karen
AU  - Collins K
AD  - Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, UK.
FAU - Reed, Malcolm
AU  - Reed M
AD  - Brighton and Sussex Medical School, Brighton, UK.
FAU - Wyld, Lynda
AU  - Wyld L
AD  - Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK.
FAU - Brain, Kate
AU  - Brain K
AD  - Division of Population Medicine, Cardiff University, Cardiff, UK, 
      liffordkj@cardiff.ac.uk.
LA  - eng
GR  - RP-PG-1209-10071/DH_/Department of Health/United Kingdom
PT  - Journal Article
DEP - 20190114
PL  - New Zealand
TA  - Patient Prefer Adherence
JT  - Patient preference and adherence
JID - 101475748
PMC - PMC6338238
OTO - NOTNLM
OT  - breast cancer
OT  - decision support
OT  - older patients
OT  - patient decision aids
OT  - shared decision-making
COIS- Disclosure The authors report no conflicts of interest in this work.
EDAT- 2019/01/27 06:00
MHDA- 2019/01/27 06:01
PMCR- 2019/01/14
CRDT- 2019/01/26 06:00
PHST- 2019/01/26 06:00 [entrez]
PHST- 2019/01/27 06:00 [pubmed]
PHST- 2019/01/27 06:01 [medline]
PHST- 2019/01/14 00:00 [pmc-release]
AID - ppa-13-131 [pii]
AID - 10.2147/PPA.S178347 [doi]
PST - epublish
SO  - Patient Prefer Adherence. 2019 Jan 14;13:131-143. doi: 10.2147/PPA.S178347. 
      eCollection 2019.