PhD Defence Linda Angelina Klaassen

Keywords: Patient Decision Aid, Breast Cancer, Aftercare, Shared decision making 
 

"Which route to take? Supporting the decision-making process of curatively treated breast cancer patients concerning their aftercare trajectory"

The research described in this dissertation investigated the development and evaluation of a decision-support tool (a patient decision aid (PtDA)) for breast cancer aftercare in the Netherlands. Since survival rates have improved, more women require follow-up care after treatment. Dutch guidelines recommend tailoring aftercare to patient preferences through shared decision making. Before this research, no such PtDA existed for breast cancer aftercare choices. 

A PtDA was developed, to help patients choose between intensive (regular hospital visits) and less intensive aftercare (telephone consultations or hospital visits when needed). The evaluation of the PtDA revealed that both patients and healthcare professionals support increased patient involvement. The PtDA shifted choices toward less intensive aftercare, slightly reducing healthcare costs, although consultation time increased. The study also found that combining analytical and intuitive preference elicitation, better matched patient’s choice for an aftercare trajectory. Finally, key factors influencing the decision to use the PtDA among healthcare professionals were identified, emphasizing the importance of patient relevance and self-efficacy. 

Click here for the live stream.