Desire for information and involvement in treatment decisions: lung cancer patients' preferences and their physicians' perceptions: results from Okayama Lung Cancer Study Group Trial 0705.
BACKGROUND
This study explores patient preferences for involvement in lung cancer treatment decisions and the extent of concordance between the views of patients and physicians on decisional roles. The impact of demographic and psychosocial characteristics on the decisional role of patients is also examined.


METHODS
Patients with relapsed non-small cell lung cancer who were candidates for a phase II trial of erlotinib monotherapy were recruited. Patients were interviewed after they had learned of their relapse and the treatment decision had been made but before pharmacologic intervention.


RESULTS
Most of the 28 participants were married, had a smoking history, and were well educated. They reported moderate levels of depression and anxiety. Initially, 14% of the patients reported a preference for active decision making; later, 29% believed that the primary responsibility for the treatment decision had been theirs. Only 54% of the patients agreed with the physician's assessment of how the treatment decision was made (κ = 0.31; test of symmetry, p = 0.23). The depression score was significantly associated with a patient's preferred level of control (p < 0.01).


CONCLUSIONS
The limited concordance between patient preference and perception and between patient and physician perceptions regarding how the treatment decision was made suggests that physicians should more accurately identify patient preferences by directly asking patients at the beginning of each clinical encounter.
Hotta
Katsuyuki
K
Department of Respiratory Medicine, Okayama University Hospital, Kitaku, Okayama, Japan. khotta@md.okayama-u.ac.jp
Kiura
Katsuyuki
K
Takigawa
Nagio
N
Yoshioka
Hiroshige
H
Hayashi
Hidetoshi
H
Fukuyama
Hajime
H
Nishiyama
Akihiro
A
Yokoyama
Toshihide
T
Kuyama
Shoichi
S
Umemura
Shigeki
S
Kato
Yuka
Y
Nogami
Naoyuki
N
Segawa
Yoshihiko
Y
Yasugi
Masayuki
M
Tabata
Masahiro
M
Tanimoto
Mitsune
M
D000230:Adenocarcinoma / Q000523:psychology* / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017322:Clinical Trials, Phase II as Topic; D003657:Decision Making; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000523:psychology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D010361:Patients / Q000523:psychology*; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D011379:Prognosis; D011446:Prospective Studies