Pharmacotherapy decision-making among patients with breast cancer in Japan: results of an online survey

Abstract

Background

Although communication between patients with breast cancer and physicians is central to treatment decision-making for patients and the concept of shared decision-making has been increasingly advocated worldwide, little is known about decision-making and perceptions among the population in Japan. Therefore, this cross-sectional study aimed to clarify the status of pharmacotherapy decision-making among patients with breast cancer in Japan and assess factors associated with patient satisfaction with patient–physician communication.

Methods

Data for women previously treated with pharmacotherapy agents for breast cancer in Japan were collected in July 2017 using an online survey. Respondents were categorized by their decision-making role (active, shared, passive). Characteristics, decisional conflict level, and satisfaction with communication with their physician at the time of pharmacotherapy selection were stratified by decision-making roles. Stepwise multivariate logistic regression was performed to assess factors associated with satisfaction.

Results

Of 486 women that responded, nearly half played an active decision-making role (48.4%) and 26.0% played a shared role. The lowest decisional conflict and higher satisfaction were observed among those who played a shared role. The highest decisional conflict and lower satisfaction were observed in passive decision-makers. Shared decision-making, a longer consultation time with the physician, and multiple treatment options provided by the physician were significantly associated with satisfaction with communication with the physician.

Conclusions

Our findings suggest that among patients with breast cancer, a shared role in treatment decision-making, longer consultation time at treatment selection, and having multiple treatment options are important for higher patient satisfaction with communication with their physician.

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Acknowledgements

This study was funded by Eisai Co., Ltd. Medical writing assistance was provided by Clinical Study Support, Inc. under contract with Eisai Co., Ltd. This study was presented in part as an abstract presentation at the 26th annual meeting of the Japanese Breast Cancer Society on May 16, 2018.

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Correspondence to Chikako Shimizu.

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Conflict of interest

Chikako Shimizu has been paid for consulting or advisory role by Eisai Co., Ltd. during the study; and outside the submitted study, been paid honoraria by AstraZeneca K.K., Kyowa Hakko Kirin Co., Ltd., Chugai Pharmaceutical Co., Ltd., ASKA Pharmaceutical Co., Ltd., and Taiho Pharmaceutical Co. Ltd.; been paid for consulting or advisory role by Eli Lilly Japan K.K., Pfizer Japan Inc., and AstraZeneca K.K.; and conducted research projects funded by Eli Lilly Japan K.K., MSD K.K., Chugai Pharmaceutical Co., Ltd., and Pfizer Japan Inc. Yukinori Sakata, Ruiko Sakai, Hiroki Ikezawa, and Toshiyuki Matsuoka are employees of Eisai Co., Ltd. Yoshiki Uetaki is an employee of Anterio Inc.

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Shimizu, C., Sakata, Y., Sakai, R. et al. Pharmacotherapy decision-making among patients with breast cancer in Japan: results of an online survey. Breast Cancer 26, 799–807 (2019). https://doi.org/10.1007/s12282-019-00986-z

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Keywords

  • Breast neoplasms
  • Decision-making
  • Communication
  • Patient preference
  • Japan