1. Medical decision making for older patients during multidisciplinary oncology team meetings
- Author
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Bolle, Sifra, Smets, Ellen M.A., Hamaker, Marije E., Loos, Eugène F., van Weert, Julia C.M., Organisation Studies, UU LEG Research USG Public Matters Organization and Management, UU LEG Research USG Public Matters, Persuasive Communication (ASCoR, FMG), Organisation Studies, UU LEG Research USG Public Matters Organization and Management, UU LEG Research USG Public Matters, Medical Psychology, APH - Quality of Care, and APH - Personalized Medicine
- Subjects
Male ,Patient characteristics ,Medical Oncology ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,Older patients ,Multidisciplinary approach ,Taverne ,Humans ,Medicine ,In patient ,030212 general & internal medicine ,Decision-making ,Aged ,Patient Care Team ,Polypharmacy ,Patient-Centred care ,Rectal Neoplasms ,business.industry ,Age Factors ,Patient Preference ,Multidisciplinary oncology team meeting ,Medical decision making ,medicine.disease ,Colorectal cancer ,Comorbidity ,Geriatric assessment ,Oncology ,030220 oncology & carcinogenesis ,Colonic Neoplasms ,Female ,Interdisciplinary communication ,Geriatrics and Gerontology ,business ,Clinical decision-making - Abstract
ObjectivesMultidisciplinary team meetings aim to facilitate efficient and accurate communication surrounding the complex process of treatment decision making for older patients with cancer. This process is even more complicated for older (≥70 years) patients as the lack of empirical evidence on treatment regimens in patients with age-related problems such as comorbidity and polypharmacy, necessitates a patient-centred approach.This study investigates the decision making process for older patients with cancer during multidisciplinary team meetings and the extent to which geriatric evaluation and geriatric expertise contribute to this process.MethodsNon-participant observations of 171 cases (≥70 years) during 30 multidisciplinary team meetings in five hospitals and systematically analysed using a medical decision making framework. All cases were in patients with colon or rectal cancer.ResultsFirst, not all steps from the medical decision making framework were followed. Second, we found limited use of patient-centred information such as (age-related) patient characteristics and patient preferences during the decision making process. Third, a geriatric perspective was largely missing in multidisciplinary team meetings.ConclusionsThis study uncovers gaps in the treatment decision making process for older patients with cancer during multidisciplinary team meetings. In particular individual vulnerabilities and patient wishes are often neglected.
- Published
- 2019