Shared decision-making in chronic lymphocytic leukemia: Preferences and perceptions of patients, providers, and navigators.

221 Background: In recent years, new treatments for chronic lymphocytic leukemia (CLL) with excellent response rates and varying toxicity profiles have emerged. In the setting of multiple available options, shared decision-making is critical. Developing strategies to enhance shared decision-making requires better understanding of how patients and providers make treatment decisions.

METHODS: Patients with CLL and health care providers within the University of Alabama at Birmingham Health System Cancer Community Network were to assess how treatment decisions are made.

RESULTS: Forty-four patients with CLL completed telephone-based surveys. The median age was 69 years old. Thirty percent had completed ≤12 years of education, 20% had some college education. Seventy-three percent of patients preferred an active or shared role in decision-making (27% preferring to make decision, 23% making decision with physician input, and 45% a shared role). Only 2% of patients preferred the doctor select the treatment. Despite >50% preferring an active role, only 20.5% perceived having an active role (Table 1). Thirty-three lay patient navigators, 26 oncologists, and 28 nurses (RN)/advanced care providers (ACP) completed web-based surveys. Navigators and nurses perceived a greater patient role in decision-making than physicians, who perceived that decisions were most often shared.

CONCLUSIONS: Patients and providers have differing perceptions of their roles in decision-making in CLL treatment. Patients desire higher levels of participation in decision-making than they perceive that they receive, suggesting an opportunity for education of patients and providers to improve shared decision-making. [Table: see text].