ASPO Abstracts
Oncologists’ Perspectives on Barriers to Effective Communication about Genomic Test Results and Preferences for Communication Aides
Category: Behavioral Science & Health Communication, Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2018
Abstract Body:
Background: Every year, thousands of women with early-stage breast cancer receive gene- expression profile (GEP) tests (such as Oncotype DX) to guide chemotherapy decisions. However, many patients report a poor understanding of their test results and related treatments. This situation could be improved by enhancing oncologist-patient communication and patient education efforts. The objectives of this study were to identify physician-perceived barriers to effective communication with patients about Oncotype DX test results and to determine what decision support tools and tool elements might be most helpful to support integration of GEP results into treatment decision-making. Methods: Medical oncologists who were part of a practice group in the Mid-Atlantic US completed an online, cross-sectional survey in 2016. These data were merged with de- identified electronic patient and practice data. Results: Of the 83 oncologists contacted, 29 completed the survey (35% response rate). Oncologists in our target population were, on average, 52 years old, 72% male and primarily (80%) White. Survey responders did not differ from non-responders on demographic or practice-related variables. There were no significant differences between survey responders and non-responders and responders treated the majority of test-eligible breast cancer patients (52%) in the practice network. Oncologists were most likely to report patient-related barriers, including patients’ performance status [65.5%], patient pre-testing preferences for chemotherapy [55.2%], and patients’ comprehension of complex test results [55.2%]). Most frequently endorsed oncologist-related barriers included their experience with testing [58.6%] and their own confidence in using the test results [48.3%]). Oncologists most preferred a web- based decision support tool that incorporates patient clinical factors, supplemented by print- based patient materials. Discussion: The barriers reported by oncologists are amenable to intervention. The preferred tool characteristics could be integrated into currently-available tools or used to develop novel tools that incorporates patient characteristics and preferences, and facilitate effective communication about the interpretation of GEP tests.
Keywords: communication, practice support tools