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Implementation,participation and satisfaction rates of a web-based decision support tool for patients with metastatic colorectal cancer
Authors:Lotte Keikes  Judith de Vos-Geelen  Jan Willem B. de Groot  Cornelis J.A. Punt  Lieke H.J. Simkens  Marija Trajkovic-Vidakovic  Johanneke E.A. Portielje  Allert H. Vos  Laurens V. Beerepoot  Cornelis B. Hunting  Miriam Koopman  Martijn G.H. van Oijen
Affiliation:1. Department of Medical Oncology, Amsterdam University Medical Centers, Location AMC, Cancer Center Amsterdam, Amsterdam, the Netherlands;2. Department of Internal Medicine, Division of Medical Oncology, GROW - School for Oncology and Developmental Biology, Maastricht UMC+, Maastricht, the Netherlands;3. Department of Medical Oncology, Isala, Zwolle, the Netherlands;4. Department of Medical Oncology, Maxima Medical Center, Veldhoven, the Netherlands;5. Department of Medical Oncology, Albert Schweitzer Hospital, Dordrecht, the Netherlands;6. Department of Medical Oncology, Haga Hospital, The Hague, the Netherlands;7. Department of Medical Oncology, Hospital Bernhoven, Uden, the Netherlands;8. Department of Medical Oncology, Elisabeth-Tweesteden Hospital, Tilburg, the Netherlands;9. Department of Medical Oncology, Antonius Hospital, Nieuwegein, the Netherlands;10. Department of Medical Oncology, University Medical Center, Utrecht, the Netherlands
Abstract:ObjectiveTo examine implementation and patients’ and providers’ participation and satisfaction of a newly developed decision support tool (DST) for patients with metastatic colorectal cancer (mCRC) in palliative setting.MethodsOur DST consisted of a consultation sheet and web-based tailored information for mCRC treatment options. We conducted an implementation trajectory in 11 Dutch hospitals and evaluated implementation, participation and satisfaction rates.ResultsImplementation rates fluctuated between 3 and 72 handed out (median:23) consultation sheets per hospital with patients’ login rates between 36% and 83% (median:57%). The majority of patients (68%) had (intermediate)-high participation scores. The median time spent using the DST was 38 min (IQR:18–56) and was highest for questions concerning patients’ perspective (5 min). Seventy-six% of patients were (very) satisfied. The provider DST rating was 7.8 (scale 1–10) and participation ranged between 25 and 100%. Remaining implementation thresholds included providers’ treatment preferences, resistance against shared decision-making and (over)confidence in shared decision-making concepts already in use.ConclusionWe implemented a DST with sufficient patient and oncologist satisfaction and high patient participation, but participation differed considerably between hospitals suggesting unequal adoption of our tool.Practice implicationsRequirements for structural implementation are to overcome remaining thresholds and increase awareness for additional decision support.
Keywords:Corresponding author at: Department of Medical Oncology, Amsterdam University Medical Centers, location AMC, Cancer Center Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands.  Metastatic colorectal cancer  Decision support tool  Shared decision-making  Patient values  Treatment preferences
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