Physicians' Awareness and Attitudes Toward Decision Aids for Patients With Cancer

Early Release, published online ahead of print Mar 30 2010
Journal of Clinical Oncology, 10.1200/JCO.2009.25.2874

Physicians' Awareness and Attitudes Toward Decision Aids for Patients With Cancer

Chantalle Brace, Selina Schmocker, Harden Huang, J. Charles Victor, Robin S. McLeod, and Erin D. Kennedy*
From the Department of Surgery, University Health Network–Toronto General Hospital; Department of Surgery, Mount Sinai Hospital; Dr Zane Cohen Digestive Disease Research Unit; and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.

Purpose: Patient decision aids are interventions designed to help patients make deliberative choices about their treatment options and have been shown to significantly improve patient outcomes. Although considered optimal, decision aids are not widely used in clinical practice for cancer treatment. The objectives of this study are to determine physicians' awareness and use of decision aids, physicians' perceptions of the major barriers to the use of decision aids, and physician characteristics predictive of use of decision aids in clinical practice.


Methods: A population-based survey was mailed to general surgeons, medical oncologists, and radiation oncologists.

Results: The survey was mailed to 878 physicians, and the overall response rate to the survey was 64.5%. The majority of the participants were male and working in community hospitals for more than 10 years. Overall, 69% of the respondents were aware of decision aids, and 46% were aware of decision aids relevant to their practice. However, only 24% were currently using decision aids. The main barriers to the use of decision aids were reported as lack of awareness, lack of resources, and lack of time. Multivariate analysis showed specialty to be the only physician characteristic influencing the use of decision aids.

Conclusion: Approximately one third of physicians treating cancer patients are not aware of what decision aids are, and only 24% are currently using decision aids in clinical practice. Strategies to increase physician awareness about decision aids and to implement these tools into clinical practice are important.