Patient, care partner, and provider voice in treatment decision-making for non-small cell lung cancer.

Abstract

Describe the treatment attributes that patients, care partners, and clinicians prioritize when making decisions about non-small cell lung cancer (NSCLC) as well as each group's perspectives regarding shared decision-making (SDM). Cross-sectional online surveys were conducted between March andMay 2023. Adult patients and care partners were recruited from Inspire, a closed online health community, and clinicians (oncologists, nurse practitioners, physician assistants) were recruited separately from M3 Global Research databases. Survey questions were informed by a literature review, interviews, and steering committee input. 160 patients and 30 care partners (0.3 % of those invited and 15 % of those who responded to the email invitation), and 150 clinicians (5 % of those invited and 43 % of those who responded to the email invitation) completed the surveys. Across all groups, expected overall survival was the most important treatment attribute. Quality of life, ranked second by patients and care partners, was ranked fourth by clinicians. When asked about SDM, 11 % of patients with early-stage NSCLC and 12 % of those with advanced disease wanted their doctor to make treatment decisions after considering their opinion. However, 53 % of clinicians thought patients preferred that they make the final decision in later disease stages. Patients with NSCLC, care partners, and clinicians generally agreed on the most important treatment attributes. However, aligning on SDM practices could help achieve more effective NSCLC management. Our study reinforces the relevance of SDM in NSCLC; however, some patients who wish for greater involvement in decisions may find their preferences overlooked.