Shared decision-making in oncology: challenges and opportunities

Newly diagnosed cancer patients often face multiple treatment options (such as chemotherapy, surgery, radiation therapy) each with their own advantages and disadvantages. Treatment choices are no longer driven purely by clinicians’ expertise but increasingly by patients’ individual values and preferences as well. This collaborative process between the two is known as shared decision-making (SDM) sometimes supported by information tools such as patient decision aids (PDAs). Implementation of SDM and PDAs often falters in practice due to a lack of attention to user perspectives and workflows. For this thesis, patients, clinicians, and nurses were interviewed to understand how they experience the decision-making process and how patient-clinician communication can be supported. Based on the results, a PDA for prostate cancer patients was developed. Also, SDM for lung cancer patients was implemented and evaluated. These findings shed light on the current clinical trajectory and the behavioural and organizational factors that influence SDM implementation success.