A new study sheds light on the factors that shape cancer treatment decisions for older adult patients with complex health and social care needs.
Researchers from the University of Southampton, UK, led by Jackie Bridges, PhD, MSN, BNurs(Hons), RN, PG Cert, conduced semi-structured interviews with 22 clinicians at five National Health Service hospital trusts who are directly involved in cancer treatment and care of patients with breast or colorectal cancers. Observations were also done to confirm the accounts of those interviewed.
The results indicated that cancer treatment decision-making is initially team-based, with the treatment plan being determined by a multidisciplinary team of surgical staff, oncologists, nurses, radiologists, and pathologists. However, the decisions made by the multidisciplinary team were almost exclusively based on the cancer pathology, rather than resulting from a more patient-centered approach.
Only after the treatment recommendations have been formulated did the patient’s health and social care needs factor into the decision-making process, and, even then, they did so in a “haphazard” manner. According to the study’s authors, this “may result in less effective and workable treatment plans, as individual clinicians struggle to devise and deliver these plans without breaching time-based targets.”
Furthermore, many clinicians reported a desire to involve older adults with cancer in decisions about their treatment but felt that time constraints within the cancer treatment pathway did not allow for the assessment and discussion of treatments that most older patients require in order to understand their options.
The findings indicate that modified decision-making processes and better structural support are needed to ensure that older adults with cancer receive adequate and timely assessment to support their involvement in decisions about their treatment.
