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Impact of Decision Aids on Breast Cancer Surgery Choice: A Randomized Controlled Trial

Not Applicable
Completed
Conditions
Breast Cancer
Interventions
Other: Decision aids
Registration Number
NCT03105076
Lead Sponsor
Taipei Medical University Shuang Ho Hospital
Brief Summary

Both simple mastectomy and breast conservation therapy (BCT) with radiotherapy yield similar survival rates in breast cancer. These two treatment strategies have diverted cosmetic outcome and convenience. Thus, shared decision making (SDM) is necessary to aid patients to choose an appropriate treatment that suits thier needs. We have developed a decision aids (DAs) and plan to conduct a randomized controlled trial (RCT) to evaluate its impact on cancer patients. The measurements include a battery of interview-based questionnaires and evaluations of decision regret and postsurgical depression. We expect the DAs would benefit the intervention group in the aspects of knowledge, communication and anxiety status during and after thier treatment sessions.

Detailed Description

Background:

For women with early-stage breast cancer, both simple mastectomy and breast conservation therapy (BCT) with radiotherapy yield similar survival rates, making psychological adjustment and quality-of-life issues pivotal in treatment choice. Using decision aids (DAs) is one way to provide information to patients and to involve them in making decisions about their treatment. We have developed a DAs to be administered after consultation for Taiwanese women deciding on breast surgery, and plan to conduct a randomized controlled trial (RCT) to evaluate the benefit of DAs on breast surgery decision making.

Patients and Methods:

Decision aids are interventions designed to help patients with early breast cancer to make deliberate choices among treatment options by providing information on those options and any potential outcome relevant to different breast cancer surgeries. Women considering breast cancer surgery are randomly assigned to receive a DAs or the standard oral conversation (control condition) after initial consultation, wherein surgeons disclosed the diagnosis and discussed treatment options with patients. Participants complete interview-based questionnaires 1 day before and 4 weeks after surgery. Primary outcome measures 1 day before surgery are decisional conflict and decision-making difficulties after consultation. Secondary outcomes are decision regret and postsurgical depression 1 month after surgery.

Hypothesis:

The DAs group are predicted to lower decisional conflict scores before surgery, and lower decision regret scores and depression scores 1 month after surgery compared with women in the control arm. Our study hopes to support the efficacy of DAs in helping breast cancer women to arrive at their breast surgery decision.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
150
Inclusion Criteria
  • Taiwanese women newly diagnosed with stage 0 to 3 breast cancer (including patients with ductal carcinoma in situ), who were suitable for breast surgery
  • Patients who were able to give consent and complete the interview
Exclusion Criteria
  • Patients were diagnosed with nonmalignant breast disease
  • Patients were offered neoadjuvant chemotherapy
  • Patients had cognitive impairment
  • Patients were physically unfit to be interviewed
  • Patients were non-Mandarin or -Taiwanese

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
DAs groupDecision aidsShared decision making using decision aids
Primary Outcome Measures
NameTimeMethod
Decisional conflict1 day before surgery

Total score of decisional conflict scale

Knowledge1 day before surgery

Total score on knowledge scale

Secondary Outcome Measures
NameTimeMethod
Decision regret4 weeks after surgery

Total score of decision regret

Postsurgical depression4 weeks after surgery

Total score of Hospital anxiety and depression scale (HADS)

Trial Locations

Locations (1)

Shuang Ho Hospital, Taipei Medical University

🇨🇳

New Taipei City, Taiwan

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