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Patient characteristics linked to degree of family involvement in treatment decisions
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A majority of patients recently diagnosed with lung or colorectal cancers chose to include family members in treatment-related decisions, according to study results.
Family-controlled decisions were most common in non–English-speaking families, but the degree of family involvement tended to vary according to patient characteristics.
Gabriella S. Hobbs, MD, of the department of medical oncology at Harvard Medical School, and colleagues evaluated data from 5,284 patients enrolled in the Cancer Care Outcomes Research and Surveillance Consortium, all of whom were newly diagnosed with lung or colon cancers. Of the participants, 53% were male and 70% were non-Hispanic white.
Researchers asked patients to choose one of five statements that best described the role their families played in their cancer treatment decision-making. The statements were:
- “You made the decision with little or no input from your family”;
- “You made the decisions after considering your family’s opinion”;
- “You and your family made the decisions together”;
- “Your family made the decisions after considering your opinion”; and
- “Your family made the decisions with little or no input from you.”
Based on their answers, decisions were categorized as having little family input, having some family input, being equally shared between the patient and family, or as family-controlled. Family-controlled decisions included those that were made after considering the patient’s opinion, as well as those made with little or no input from the patient.
Results showed that 49.4% of respondents reported an equally shared decision-making process, and 22.1% reported some input from family. More than a quarter (28.5%) reported little to no input from family members, whereas 1.5% reported decisions that were completely family-controlled.
Equally shared family decision-making was more common among Spanish-speaking Hispanic patients (54.8%) and non-English speaking Asian patients (59.8%) compared with non-Hispanic white patients (47.6%). Family-influenced decisions also were more common among patients who were married, female, older and insured (P ˂ .001).
Military veterans represented the patient group least likely to seek family input in the decision-making process (P ˂ .001).
Knowledge of how patients make decisions and the level of family involvement in the decision-making process will help doctors augment patient participation in treatment options, researchers wrote.
“Our study suggests that not all patients wish to include family in the same way,” Hobbs said in a press release. “By raising awareness of these preferences, we hope that physicians will be aware of these variations and elicit their patient’s preference on how they wish to include, or not to include, families in decision-making.” – by Cameron Kelsall
Disclosure: Hobbs reports no relevant financial disclosures. The other researchers report funding from the NCI to their institutions as part of this study, as well as grants from McKinsey and Company and Greylock McKinnon Associates for work performed outside of the current study.
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