University of Sussex
Browse
2019_Age Gap.pdf (1.54 MB)

Efficient development and usability testing of decision support interventions for older women with breast cancer

Download (1.54 MB)
journal contribution
posted on 2023-06-09, 16:09 authored by Kate J Lifford, Adrian Edwards, Maria Burton, Helena HarderHelena Harder, Fiona Armitage, Jenna Morgan, Lisa Caldon, Kirsty Balachandran, Alistair Ring, Karren Collins, Malcolm ReedMalcolm Reed, Lynda Wyld, Kate Brain
Around a third of breast cancers diagnosed each year in the UK are in women aged 70 years and older. However, there are currently no decision support interventions for older women who have a choice between primary endocrine therapy and surgery followed by adjuvant endocrine therapy (surgery+endocrine therapy), or who can choose whether or not to have chemotherapy following surgery. There is also little evidence-based guidance specifically on the management of these older patients. A large UK cohort study is currently underway to address this lack of evidence and to develop two decision support interventions (DESIs) to facilitate shared decision-making with older women about breast cancer treatments. Here we present the development and initial testing of these two DESIs. An initial prototype DESI was developed for the choice of primary endocrine therapy or surgery+endocrine therapy. Semi-structured interviews with healthy volunteers and patients explored DESI acceptability, usability and utility. A framework approach was used for analysis. A second DESI for the choice of having chemotherapy or not was subsequently developed based on more focused development and testing. Participants (n=22, aged 75-94 years, 64% healthy volunteers, 36% patients) found the primary endocrine therapy/surgery+endocrine therapy DESI acceptable, and contributed to improved wording and illustrations to address misunderstandings. The chemotherapy DESI (tested with 14 participants, aged 70-87 years, 57% healthy volunteers, 43% patients) was mostly understandable, however suggestions for re-wording sections were made. Most participants considered the DESIs helpful, but highlighted the importance of complementary discussions with clinicians. It was possible to use a template DESI to efficiently create a second prototype for a different treatment option (chemotherapy). Both DESIs were acceptable and considered helpful to support/augment consultations. Development of acceptable additional DESIs for similar target populations using simplified methods may be an efficient way to develop future DESIs. Further research is needed to test the effectiveness of the DESIs.

Funding

Bridging the age gap in breast cancer. Improving outcomes for older women; G1855; NATIONAL INSTITUTE FOR HEALTH RESEARCH; R/127870

History

Publication status

  • Published

File Version

  • Published version

Journal

Patient Preference and Adherence

ISSN

1177-889X

Publisher

Dovepress

Issue

13

Volume

2019

Page range

131-143

Department affiliated with

  • BSMS Neuroscience Publications

Research groups affiliated with

  • Sussex Health Outcomes Research and Education in Cancer Publications

Full text available

  • Yes

Peer reviewed?

  • Yes

Legacy Posted Date

2018-12-05

First Open Access (FOA) Date

2019-01-16

First Compliant Deposit (FCD) Date

2018-12-04

Usage metrics

    University of Sussex (Publications)

    Categories

    No categories selected

    Exports

    RefWorks
    BibTeX
    Ref. manager
    Endnote
    DataCite
    NLM
    DC