Abstract 1520P
Background
The impact of being diagnosed with a life-threatening illness may influence preferences to participate in treatment decisions. The objective of this study was to identify factors that are associated with sarcoma patients wanting to take a more active or passive role.
Methods
Data was obtained as part of a nationwide multicenter trial (PROSa) aiming to investigate the structure and quality of medical care of sarcoma patients in Germany. The study was conducted between 2017 and 2020 in 39 study centers. For the present analysis, cross-sectional data of adult patients with sarcoma of any entity were analyzed. Control preference was measured with the control preference scale (CPS). Preferences were divided in patient-led, shared, or physician-led-decision-making. Associated factors were analyzed exploratively using multivariable nominal logistic regression models. We included socio-economical and medical variables with stepwise backward variable selection.
Results
We included 1059 patients (51.5 % male). 394 patients wanted to make their own treatment decision while 275 patients preferred the physician to make treatment decisions on their behalf. 390 patients wanted to share responsibility. Comparing patients’ preferences to participate, we found the following significant differences: Patient without metastases were more likely to make their own treatment decisions than patients with a metastatic tumor disease who preferred to share responsibility (OR 1.50, 95% CI 1.04; 2.16). With patients between 18 and >40 years as reference category, older patients were less likely to make the decision by themselves: age group: 55-<65 (Odds Ratio (OR) 0.50, 95% confidence interval (95% CI) 0.29; 0.88), age group: 65-<75 (OR 0.39, 95% CI 0.22; 0.69), age group: ≥75 years (OR 0.29, 95% CI 0.15; 0.56). Patients with an education level of high school or higher were more likely to make decisions by themself than those with 8 or 9 years of school education (OR 1.94, 95% CI 1.24; 3.05).
Conclusions
The findings of our study demonstrate that patients with metastatic disease are more likely to seek a joint decision, while those with higher age and lower education level are unlikely to seek an active role in treatment decision making.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
German Cancer Aid (No. 111713).
Disclosure
All authors have declared no conflicts of interest.