Clearly choosing treatments that extend expected survival is important, but survival expectations are not the only factor that matters to cancer patients. A 2017 NCCN policy report–based on the findings from a working group–identifies a number of factors:
Patients, for example, may view high-value care as any combination of trust, transparency, and effective communication with providers; care coordination; survivorship care; quality of life (QOL); toxicity management; limited travel for care; and limited financial risk. To this end, patient care is highly individualized.
While patients may have their own preferences, one relevant question is whether patients really want to make these tough decisions or if they want physicians to largely pick for them. Most, but not all, research indicates that patients want information and tools to make informed treatment decisions with their providers.
Recent survey data from Cancer Support Community supports these identified gaps, finding that a quarter of the 1,046 patients surveyed did not feel confident they received the care that they needed, with more than a third of respondents indicating they would have liked to have been more involved in decisions about their care and treatment options.
The authors, thus, call for more tools to help patients make informed decisions about treatment benefits, risks and costs.
Moving forward, it is important to develop measurement capacity in a value tool framework that is sensitive to cost, distress, and the individual existential experience of the cancer care journey, thus informing and shaping high-quality cancer care.
- Winckworth-Prejsnar, Katy, Lisa Korin Lentz, Elizabeth A. Nardi, Sandhya Pruthi, C. Lyn Fitzgerald, and Robert W. Carlson. “Value Tools for Patients in Cancer Care.” Journal of the National Comprehensive Cancer Network 15, no. 7 (2017): 872-877.