Implementation, participation and satisfaction rates of a web-based decision support tool for patients with metastatic colorectal cancer

• Published in: Patient education and counseling 2019-07, Vol.102 (7), p.1331-1335
• Main Authors: Keikes, Lotte, de Vos-Geelen, Judith, de Groot, Jan Willem B., Punt, Cornelis J.A., Simkens, Lieke H.J., Trajkovic-Vidakovic, Marija, Portielje, Johanneke E.A., Vos, Allert H., Beerepoot, Laurens V., Hunting, Cornelis B., Koopman, Miriam, van Oijen, Martijn G.H.
• Format: Article
• Language: English
• Subjects: Aged; Colorectal Neoplasms - therapy; Decision Support Techniques; Decision support tool; Female; Humans; Internet; Male; Metastatic colorectal cancer; Middle Aged; Neoplasm Metastasis; Netherlands; Nursing; Palliative Care; Patient Satisfaction; Patient values; Shared decision-making; Treatment preferences
• ISSN: 0738-3991; 1873-5134
• DOI: 10.1016/j.pec.2019.02.020

•There is need for additional decision support for mCRC patients in palliative setting.•This study focuses on implementation of a decision support tool for mCRC patients.•There are remarkable implementation differences between participating hospitals.•Challenges are to overcome remaining thresholds and structural implementation.•Awareness for additional decision support is required before structural implementation. To examine implementation and patients’ and providers’ participation and satisfaction of a newly developed decision support tool (DST) for patients with metastatic colorectal cancer (mCRC) in palliative setting. Our DST consisted of a consultation sheet and web-based tailored information for mCRC treatment options. We conducted an implementation trajectory in 11 Dutch hospitals and evaluated implementation, participation and satisfaction rates. Implementation rates fluctuated between 3 and 72 handed out (median:23) consultation sheets per hospital with patients’ login rates between 36% and 83% (median:57%). The majority of patients (68%) had (intermediate)-high participation scores. The median time spent using the DST was 38 min (IQR:18–56) and was highest for questions concerning patients’ perspective (5 min). Seventy-six% of patients were (very) satisfied. The provider DST rating was 7.8 (scale 1–10) and participation ranged between 25 and 100%. Remaining implementation thresholds included providers’ treatment preferences, resistance against shared decision-making and (over)confidence in shared decision-making concepts already in use. We implemented a DST with sufficient patient and oncologist satisfaction and high patient participation, but participation differed considerably between hospitals suggesting unequal adoption of our tool. Requirements for structural implementation are to overcome remaining thresholds and increase awareness for additional decision support.