Variation in Patient-Reported Decision-Making Roles in the Last Year of Life among Patients with Metastatic Cancer: A Longitudinal Study

Semra Ozdemir, Isha Chaudhry, Si Ning Germaine Tan, Irene Teo, Chetna Malhotra, Rahul Malhotra and Eric Andrew Finkelstein
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Semra Ozdemir: Signature Program in Health Services and Systems Research; Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
Isha Chaudhry: Signature Program in Health Services and Systems Research; Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
Si Ning Germaine Tan: Signature Program in Health Services and Systems Research; Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
Irene Teo: Signature Program in Health Services and Systems Research; Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
Chetna Malhotra: Signature Program in Health Services and Systems Research; Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
Rahul Malhotra: Signature Program in Health Services and Systems Research; Centre for Aging Research and Education, Duke-NUS Medical School, Singapore
Eric Andrew Finkelstein: Signature Program in Health Services and Systems Research; Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore

Medical Decision Making, 2023, vol. 43, issue 2, 203-213

Abstract: Objective We investigated the variation in patient-reported decision-making roles in the past year of life among patients with metastatic solid cancer and the associations of these roles with patient quality of life and perceived quality of care. Methods We used the last year of life data of 393 deceased patients from a prospective cohort study. Patients reported their decision-making roles, quality of life (emotional well-being, spiritual well-being, and psychological distress) and perceived quality of care (care coordination and physician communication) every 3 months until death. We used mixed effects linear regressions to investigate the associations of decision-making roles with patients’ quality of life and perceived quality of care. Results The most reported roles, on average, were patient-led (37.9%) and joint (23.4%; with physicians and/or family caregivers) decision making, followed by no patient involvement (14.8%), physician/family-led (12.9%), and patient alone (11.0%) decision making. Patient level of involvement in decision making decreased slightly as death approached ( P

Keywords: decision making; last year of life; quality of life; quality of care; advanced cancer (search for similar items in EconPapers)
Date: 2023
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:43:y:2023:i:2:p:203-213

DOI: 10.1177/0272989X221131305

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