Family members often play an important role in providing care for patients with cancer, but which patients are more or less likely to involve family members in decisions regarding their care is not well known. A new study published early online in CANCER, a peer-reviewed journal of the American Cancer Society, provides some insights and may help physicians understand patients' preferences regarding their care.
For the study, Gabriella Hobbs, MD, and Nancy Keating, MD, MPH, of Harvard Medical School, and their colleagues surveyed 5284 patients with a new diagnosis of lung or colon cancer, and asked participants how they involved their families in decisions about their care. Only 1.5 percent of patients reported family-controlled decisions. Among the remaining patients, 49.4 percent reported equally sharing decisions with family, 22.1 percent reported some family input, and 28.5 percent reported little or no input from their families. Non-English speaking Asian patients and Spanish-speaking Hispanic patients were more likely to report equally shared decisions with their families than other patients. Also, patients who were married, female, older, and insured more often equally shared decision-making with their families than their counterparts. Patients who were veterans were the least likely to share decision-making with their families.
"Understanding how patients vary in their inclusion of family members in decisions--by ethnicity, language spoken, marital status, sex, age, insurance status, and veteran status--may help physicians to better assess their patients' preferences for engaging family members in decisions," said Dr. Hobbs. "As we move to more patient-centered models of care, such assessments may help doctors personalize the care they offer their patients."
Dr. Hobbs noted that as therapies for cancer patients improve, they are also becoming increasingly complex, making it challenging for patients and providers to determine the optimal therapy for each patient. With this in mind, knowing how patients make decisions and understanding the role that families play in decision-making is crucial for optimizing patient participation in treatment decisions. "Our study suggests that not all patients wish to include family in the same way. By raising awareness of these preferences, we hope that physicians will be aware of these variations and elicit their patient's preference on how they wish to include, or not to include, families in decision-making."