Evidence on patient decision aids and shared decision-making across breast centers in Europe: a cross-sectional survey study

Introduction Patient-centricity calls for accurate consideration of patients’ preferences at every step of the care pathway. Decision aids (DAs) are interventions that provide patients with information about treatment options, enabling shared decision-making (SDM). This study investigated the practice of SDM by breast cancer (BC) specialists and the diffusion of DAs in the treatment of BC in Europe. The secondary objective of the study was to explore heterogeneity across respondents’ subgroups. Methods A prospective, cross-sectional, cross-country questionnaire targeting breast specialists was distributed online across breast cancer networks at both national and European level. The survey results were analyzed descriptively. Mann-Whitney-U tests, and probit regressions were performed to explore differences between subgroups. Results Respondents were mostly medical oncologists and surgeons. Respondents expressed high comfort with SDM approach (mean: 4.29, CI95%: 4.15-4.44). The majority reported DAs were available, and used, in their organization. Statistically significant gender differences were observed, indicating that female physicians might be more prone to adopting SDM approaches with patients. Conclusions Patient-centricity calls for consideration of patients’ values. The specialists in this survey showed a promising attitude towards SDM. DAs availability translates into use, although this mainly refers to paper tools, whereas digital tools seem mostly illustrated in the literature.