title: [Multidisciplinary consultation meetings: decision-making in palliative chemotherapy].
abstract: BACKGROUND
  Multidisciplinary consultation meetings provide an opportunity for specialists from different disciplines to engage in formal discussions over diagnostic and therapeutic strategies in oncology. In complex clinical situations, specialists discuss medical decisions collectively, particularly in cases involving palliative chemotherapy. The purpose of this study was to identify the factors considered in multidisciplinary consultation meetings in deciding whether palliative chemotherapy is needed.
  
  
  METHODS
  A study was conducted over a three-month period in an adult hematology department in order to identify the criteria used in weekly multidisciplinary consultation meetings to determine whether palliative chemotherapy is required. The study only included patients who were confirmed to be in the palliative phase by all the doctors present at the multidisciplinary consultation meetings. The criteria cover 5 areas related to patient's characteristics, patients'environment, the disease, scientific data and the objectives of palliative chemotherapy.
  
  
  RESULTS
  The criteria considered in 100% of cases were related to the disease, the expected benefits of chemotherapy with palliative intent and patients' characteristics. The least important criteria were related to the patients' environment. Scientific data were not discussed during the multidisciplinary consultation meetings.
  
  
  CONCLUSIONS
  The results show that the criteria used to determine whether chemotherapy with palliative intent is required are essentially of a medical nature. However, in palliative situations, factors related to patients' environment must be taken into account. In order to meet this requirement, it may be necessary to increase the participation of paramedical professionals and palliative care teams in multidisciplinary consultation meetings and to promote dialogue and collaboration with doctors and coordinating nurses.
authors: Equipe mobile d'accompagnement et de médecine palliative pédiatrique et adulte, Hôpital Necker Enfants Malades - Assistance Pùblique des Hôpitaux de Paris. aude.ledivenah@nck.aphp.fr
authors: Aude
authors: A
authors: Le Divenah
authors: Stéphane
authors: S
authors: David
authors: Dominique
authors: D
authors: Bertrand
authors: Tanguy
authors: T
authors: Chatel
authors: Marcel-Louis
authors: ML
authors: Viallards
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D003657:Decision Making; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy; D010166:Palliative Care; D010348:Patient Care Team; D011446:Prospective Studies
chemical_list: D000970:Antineoplastic Agents