Just 1 in 4 CRC Treatment Guidelines Mention Shared Decision Making

The majority of guidelines for the treatment of patients with colorectal cancer (CRC) and anal cancer fail to mention shared decision-making, according to a systematic review published in the journal Patient Education and Counseling.

“Whenever shared decision-making was reported, its description, recommendations, and advice for implementation were scarce, leaving an enormous range for improvement,” wrote corresponding author Marta Maes-Carballo, MD, of the University of Granada in Spain, and study coauthors.

With the development of more personalized treatments for patients with CRC and anal cancer in recent years, study authors were interested in the presence and quality of shared decision-making advice in clinical recommendations. Their resulting systematic review included 134 clinical practice guidelines and consensus statements.

Shared decision making was mentioned in just 34.3% of the documents. When shared decision making was included, the guidance was superficial, according to the assessment. A mere 11.1% of guidelines offered recommendations that were clear, precise, and actionable.

Guidelines based on systematic reviews mentioned shared decision making more often than guidelines based on consensus or literature reviews (35.9% vs 32.0%), researchers reported. Similarly, guidelines that reported the use of quality tools for guideline development, such as AGREE II, mentioned shared decision making more often than those that did not (75.0% vs 32.0%).

“Recommendations about shared decision making in these guidelines merit urgent improvement,” researchers concluded.

Reference

Maes-Carballo M, Gómez-Fandiño Y, García-García M, et al. Colorectal cancer treatment guidelines and shared decision making quality and reporting assessment: systematic review. Patient Educ Couns. 2023;115:107856. doi:10.1016/j.pec.2023.107856