@article{7c6b90b78faa453895154eb97c202454,
title = "Implementing a patient decision aid, a process evaluation of a large-scale pre- and post-implementation trial",
abstract = "Purpose: Patient decision aids (PtDAs) have been reported to have a positive influence on patients making a health care decision in trials. Nevertheless, post-trial implementation is poor. The aim of this study is to explore patient, clinician, and organizational success factors for implementing a PtDA designed for breast cancer patients, facing a decision on their radiation treatment. Methods: We performed a process evaluation within a multi-center pre- and post-implementation trial. The PtDA was incorporated as much as possible in the logistics of 13 participating centers. Tracking data were collected on PtDA use. Process characteristics were recorded by both clinicians and patients. A logistic regression method was applied to investigate which process characteristics were significantly related to the probability that patients logged in to the PtDA. Results: 189 patients received the PtDA of whom140 (77%) used the PtDA. If patients received the link via the surgery department they were more likely to use the PtDA (OR 9.77 (1.28–74.51)), compared to patients that received the link via the radiation oncology department. If the report of the multidisciplinary team stated that radiation treatment “had to be discussed with the patient”, patients were more likely to use the PtDA (OR 2.29 (1.12–4.71)). Educational level was not related to the probability of PtDA use. Conclusions: We accomplished a high level of PtDA use. Patients were more likely to use the PtDA if they received the link via the surgery department and if “to be discussed with the patient” was written in the multidisciplinary team report.",
keywords = "Breast irradiation, Implementation, Patient decision aid, Shared decision-making",
author = "{Raphael Daniela}, {D. B.} and Russell, {N. S.} and {van Werkhoven}, E. and Immink, {J. M.} and Westhoff, {D. P. G.} and {Stenfert Kroese}, {M. C.} and Stam, {M. R.} and {van Maurik}, {L. M.} and {van Gestel}, {C. M. J.} and {van der Weijden}, T. and Boersma, {L. J.}",
note = "Funding Information: This study is funded by the Dutch Cancer Society, Alpe d?HuZes (Grant No. MAC2014-7024). We would like to thank all patients for participating in the trial. We would also like to thank all principal investigators, trial managers and including clinicians in the participating Centers: Maastro, Antoni van Leeuwenhoek, Reinier de Graaf Hospital, Leiden University Medical Center, Radboud University Medical Center, Radiotherapy Group, Amsterdam University Medical Centers, University Medical Center Utrecht, University Medical Center Groningen, Erasmus Medical Center Cancer Institute, Haga Hospital, Haaglanden Medical Center, Southwest Radiotherapy Institute, Catharina Hospital and, Radiotherapy Institute Friesland. Funding Information: This study is funded by the Dutch Cancer Society, Alpe d{\textquoteright}HuZes (Grant No. MAC2014-7024). We would like to thank all patients for participating in the trial. We would also like to thank all principal investigators, trial managers and including clinicians in the participating Centers: Maastro, Antoni van Leeuwenhoek, Reinier de Graaf Hospital, Leiden University Medical Center, Radboud University Medical Center, Radiotherapy Group, Amsterdam University Medical Centers, University Medical Center Utrecht, University Medical Center Groningen, Erasmus Medical Center Cancer Institute, Haga Hospital, Haaglanden Medical Center, Southwest Radiotherapy Institute, Catharina Hospital and, Radiotherapy Institute Friesland. Publisher Copyright: {\textcopyright} 2020, The Author(s).",
year = "2021",
month = feb,
doi = "https://doi.org/10.1007/s10549-020-05975-x",
language = "English",
volume = "185",
pages = "685--695",
journal = "Breast cancer research and treatment",
issn = "0167-6806",
publisher = "Springer New York",
number = "3",
}