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058 Helps and hindrances to shared decision-making in France: an online national survey among cancer patients
  1. Sandra Doucene1,
  2. Léna Milan2,
  3. Gilbert Lenoir1,
  4. Fadila Farsi1,3,
  5. Nora Moumjid4,5,6,
  6. François Blot1,7
  1. 1Cancer Contribution Association, Villejuif, Paris
  2. 2Paris Cité University, Psychopathology and Health Process research unit, Boulogne-Billancourt, France
  3. 3ONCO-AURA Regional cancer network, Lyon, France
  4. 4Pathways, Health, Systemic, P
  5. 2S UR 4129, Lyon, France
  6. 5Lyon 1 University, Lyon, France
  7. 6Léon Bérard Cancer Centre, Lyon, France
  8. 7Gustave Roussy Institute, Cancer Campus Grand Paris, Villejuif, France

Abstract

In 2021, with a view to the presidential elections in France, and in order to prepare the collective reflection and significantly contribute to the debate on so-called health democracy, Cancer Contribution, a cancer patients association, conducted a national survey on shared decision-making (SDM) to identify helps and hindrances from their points of views.

From August to October 2021, the digital platform Cancer contribution conducted an online survey relayed by 11 patients representatives associations.

Out of 916 responses, 727 were analyzed: 394 from patients with hematological malignancies [HM], 185 with breast cancer [BC], 93 with other solid tumors [ST] and 55 with multiple cancers [MC].

Among participants, 47.2% reported that they participated in a decision about their health management, with a significant variation according to the pathology (BC 43.8%, HM 41.1%, ST 57%, MC 60%, P=0.01), and regardless of age and gender.

Two-thirds felt comfortable with SDM in relation with the time allocated and the information provided, regardless of the pathology.

Emotions, uncertainty and lack of information mainly explained their lack of ease in making a decision.

Less than half of patients declared that they have been involved in SDM, with variations according to the type of solid tumor or hematological malignancy.

To improve SDM implementation in routine clinical practice in cancer, sufficient time and use of decision aids are needed. Recognition of cognitive biases and emotions should help to design a training for healthcare professionals integrating these factors and to adapt information and decision aids.

Finally, referral to reliable third parties such as high-quality websites and patients’ associations, insufficiently used at the time of decision-making, is a support that needs to be encouraged.

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