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Variation in Patient-Reported Decision-Making Roles in the Last Year of Life among Patients with Metastatic Cancer: A Longitudinal Study

Author

Listed:
  • Semra Ozdemir

    (Signature Program in Health Services and Systems Research; Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
    Saw Swee Hock School of Public Health, National University of Singapore, Singapore)

  • Isha Chaudhry

    (Signature Program in Health Services and Systems Research; Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
    Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore)

  • Si Ning Germaine Tan

    (Signature Program in Health Services and Systems Research; Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
    Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore)

  • Irene Teo

    (Signature Program in Health Services and Systems Research; Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
    National Cancer Centre Singapore, Singapore)

  • Chetna Malhotra

    (Signature Program in Health Services and Systems Research; Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore)

  • Rahul Malhotra

    (Signature Program in Health Services and Systems Research; Centre for Aging Research and Education, Duke-NUS Medical School, Singapore)

  • Eric Andrew Finkelstein

    (Signature Program in Health Services and Systems Research; Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
    Saw Swee Hock School of Public Health, National University of Singapore, Singapore
    Duke Global Health Institute, Duke University, USA)

Abstract

Objective We investigated the variation in patient-reported decision-making roles in the past year of life among patients with metastatic solid cancer and the associations of these roles with patient quality of life and perceived quality of care. Methods We used the last year of life data of 393 deceased patients from a prospective cohort study. Patients reported their decision-making roles, quality of life (emotional well-being, spiritual well-being, and psychological distress) and perceived quality of care (care coordination and physician communication) every 3 months until death. We used mixed effects linear regressions to investigate the associations of decision-making roles with patients’ quality of life and perceived quality of care. Results The most reported roles, on average, were patient-led (37.9%) and joint (23.4%; with physicians and/or family caregivers) decision making, followed by no patient involvement (14.8%), physician/family-led (12.9%), and patient alone (11.0%) decision making. Patient level of involvement in decision making decreased slightly as death approached ( P

Suggested Citation

  • Semra Ozdemir & Isha Chaudhry & Si Ning Germaine Tan & Irene Teo & Chetna Malhotra & Rahul Malhotra & Eric Andrew Finkelstein, 2023. "Variation in Patient-Reported Decision-Making Roles in the Last Year of Life among Patients with Metastatic Cancer: A Longitudinal Study," Medical Decision Making, , vol. 43(2), pages 203-213, February.
    • Handle: RePEc:sae:medema:v:43:y:2023:i:2:p:203-213
    DOI: 10.1177/0272989X221131305
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    References listed on IDEAS

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    1. L. Aubree Shay & Jennifer Elston Lafata, 2015. "Where Is the Evidence? A Systematic Review of Shared Decision Making and Patient Outcomes," Medical Decision Making, , vol. 35(1), pages 114-131, January.
    2. Dana L. Alden & John Friend & Ping Yein Lee & Yew Kong Lee & Lyndal Trevena & Chirk Jenn Ng & Sorapop Kiatpongsan & Khatijah Lim Abdullah & Miho Tanaka & Supanida Limpongsanurak, 2018. "Who Decides: Me or We? Family Involvement in Medical Decision Making in Eastern and Western Countries," Medical Decision Making, , vol. 38(1), pages 14-25, January.
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    1. Semra Ozdemir & Jia Jia Lee & Khung Keong Yeo & Kheng Leng David Sim & Eric Andrew Finkelstein & Chetna Malhotra, 2023. "A Prospective Cohort Study of Medical Decision-Making Roles and Their Associations with Patient Characteristics and Patient-Reported Outcomes among Patients with Heart Failure," Medical Decision Making, , vol. 43(7-8), pages 863-874, October.

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