The role of families in decisions regarding cancer treatments

Gabriela S. Hobbs, Mary Beth Landrum, Neeraj K. Arora, Patricia A. Ganz, Michelle Van Ryn, Jane C. Weeks, Jennifer W. Mack, Nancy L. Keating

Research output: Contribution to journalArticle

48 Scopus citations

Abstract

BACKGROUND Shared decision-making is an important component of patient-centered care and is associated with improved outcomes. To the authors' knowledge, little is known concerning the extent and predictors of the involvement of a patient's family in decisions regarding cancer treatments. METHODS The Cancer Care Outcomes Research and Surveillance (CanCORS) Consortium is a large, multiregional, prospective cohort study of the cancer care and outcomes of patients with lung and colorectal cancer. Participants reported the roles of their families in decision-making regarding treatment. Multinomial logistic regression was used to assess patient factors associated with family roles in decisions. RESULTS Among 5284 patients, 80 (1.5%) reported family-controlled decisions, with the highest adjusted rates (12.8%) noted among non-English-speaking Asians. Among the 5204 remaining patients, 49.4% reported equally sharing decisions with family, 22.1% reported some family input, and 28.5% reported little family input. In adjusted analyses, patients who were married, female, older, and insured more often reported equally shared decisions with family (all P <.001). Adjusted family involvement varied by race/ethnicity and language, with Chinese-speaking Asian (59.8%) and Spanish-speaking Hispanic (54.8%) patients equally sharing decisions with family more often than white individuals (47.6%). Veterans Affairs patients were least likely to report sharing decisions with family, even after adjustment for marital status and social support (P <.001). CONCLUSIONS The majority of patients with newly diagnosed lung or colorectal cancer involve family members in treatment decisions. Non-English-speaking Asians and Hispanics rely significantly on family. Further studies are needed to determine the impact of family involvement in treatment decisions on outcomes; until then, physicians should consider eliciting patients' preferences for family involvement. Cancer 2015;121:1079-1087.

Original languageEnglish (US)
Pages (from-to)1079-1087
Number of pages9
JournalCancer
Volume121
Issue number7
DOIs
StatePublished - Apr 1 2015

Keywords

  • cohort study
  • colorectal neoplasms
  • decision-making
  • lung neoplasms
  • professional-family relations
  • shared

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Hobbs, G. S., Landrum, M. B., Arora, N. K., Ganz, P. A., Van Ryn, M., Weeks, J. C., Mack, J. W., & Keating, N. L. (2015). The role of families in decisions regarding cancer treatments. Cancer, 121(7), 1079-1087. https://doi.org/10.1002/cncr.29064