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Encounter Decision Aids Can Prompt Breast Cancer Surgery Cost Discussions: Analysis of Recorded Consultations
- Source :
- Medical decision making : an international journal of the Society for Medical Decision Making. 40(1)
- Publication Year :
- 2019
-
Abstract
- Background. Patients frequently worry about care costs, but clinicians seldom address the topic. Cost information is not typically included in patient decision aids (DAs). We examined whether including cost information in an encounter DA, with clinician training, influenced cost conversations. Method. As part of a larger trial, 14 surgeons from 4 cancer centers were randomized to 1 of 3 interventions: (1) Picture Option Grid DA that included a prompt to discuss relative treatment costs, hereafter called “cost prompt group”; (2) a text-only Option Grid DA that did not include cost information; (3) usual care. Groups 2 and 3 hereafter are referred to as “non-cost prompt groups.” Adult (18+) female patients, with stages I-IIIA breast cancer, eligible for both breast-conserving surgery and mastectomy were included. We gave surgeons feedback about adherence to the study protocol at 3, 6, and 12-months. We adapted a checklist to code the content of the audio-recorded clinical encounters. Results. 424/622 (68%) patients consented; 311 (73%) were eligible and successfully recorded (143 in the cost prompt group, 168 in the non-cost prompt groups). Costs were discussed in 132/311 (42.4%) encounters, and occurred more often in the cost prompt versus non-cost prompt groups (66.7% versus 33.3%; p
- Subjects :
- Adult
medicine.medical_specialty
media_common.quotation_subject
Breast Neoplasms
Cancer Care Facilities
Decision Support Techniques
03 medical and health sciences
0302 clinical medicine
Breast cancer
medicine
Decision aids
Humans
In patient
030212 general & internal medicine
Referral and Consultation
health care economics and organizations
Mastectomy
media_common
Aged
Physician-Patient Relations
business.industry
Health Policy
Health Care Costs
Middle Aged
medicine.disease
United States
030220 oncology & carcinogenesis
Family medicine
Female
Worry
business
Subjects
Details
- ISSN :
- 1552681X
- Volume :
- 40
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Medical decision making : an international journal of the Society for Medical Decision Making
- Accession number :
- edsair.doi.dedup.....1c26dda26d1f18b79bba04da6877f7f7