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276 Mind the gap: discrepancies between experienced and desired shared decision-making in a Dutch radiotherapy centre
  1. AR Van Hienen1,
  2. CJW Offermann2,
  3. LJ Boersma1,
  4. MJG Jacobs3,
  5. RRR Fijten1
  1. 1Department of Radiation Oncology (Maastro), Grow-school for Oncology and Reproduction, Maastricht University Medical Centre, Maastricht, The Netherlands
  2. 2Department of Research Affairs, Maastro Clinic, Maastricht, The Netherlands
  3. 3Department of Management, Tilburg University, Tilburg, The Netherlands


Introduction Implementing shared decision-making (SDM) has been challenging, in particular in the radiotherapy domain. One way to generate momentum among physicians is to understand patients’ experiences and desires regarding SDM. This study’s aim was to identify patients’ current experienced and desired level of SDM in a Dutch academic radiotherapy centre through a survey.

Methods A cross-sectional survey study adapted from the SDM survey by the Dutch Cancer Patient Federation,1 was performed. Eligible participants had undergone a radiotherapy intake consultation with a radiation oncologist between 2020 and 2022.

Results The survey was distributed to 7158 patients, with 1799 respondents. 88,0% preferred SDM, while only 23,1% felt like they participated in decision making. Among those feeling involved in the decision- making process, merely 50% recalled having more than one option and 29,3% was aware of being able to participate in SDM beforehand. Still, these patients were mostly satisfied with their radiation oncologist’s explanation of their health situation (98,4%), value elicitation (97,8%) and consideration (96,9%), and 89,3% was satisfied with their final treatment decision.

Discussion Despite a high desire, the level at which patients experience SDM in radiotherapy falls below the Dutch oncology average.1 This might be influenced by its position in care pathways, where decisions with medical oncologists precede decisions with radiation oncologists. Additionally, patient knowledge of SDM appears limited, as only half of those participating in decision making was given more than one option and 70% was unaware of the ability to participate in SDM beforehand at all.

Conclusion The discrepancy between patients’ desire for and their experiences with SDM emphasizes the need for the implementation of effective, multilevel SDM interventions in radiotherapy. Bridging this gap is essential to meet national standards and might improve patient satisfaction.


  1. Kuijpers MMT, van Veenendaal H, Engelen V, Visserman E, Noteboom EA, Stiggelbout AM, May AM, de Wit N, van der Wall E, Helsper CW. Eur. J. Cancer Care. 2021;31(1):e13534.

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