Implementation, participation and satisfaction rates of a web-based decision support tool for patients with metastatic colorectal cancer

Background: The use of decision support tools facilitates shared decision-making, but effective implementation of these tools with adequate patient and provider participation is challenging. Our study aims to effectively implement a newly developed patient-centred decision support tool for patients with metastatic colorectal cancer with sufficient patients’ and providers’ participation and satisfaction.

Methods: We conducted a patients’ and oncologists’ needs assessment and developed a decision support tool consisting of a consultation tool and web-based information about treatment options. Between July 2016 (launch) and February 2017, we measured patient participation with log in rates and time spent by online tracking and calculated participation sum scores (low, intermediate and high). Patient satisfaction was voluntarily obtained during online support. We measured oncologist participation in 11 centers by the number of oncologists that handed out at least 1 consultation tool. Satisfaction was measured by structured interviews and a survey.

Results: Implementation rates differed between 3 and 72 handed out (median 23) consultation tools per centre with a median patients’ log in rate of 57% (range 39-83%). The majority of patients (68%) had an intermediate high or high participation sum score. The median time spent during online support was highest for questions about patients’ perspective (5 mins) and colorectal cancer information (4 mins). Patient satisfaction was 76%. Oncologists’ participation per centre ranged from 25 to 100%. The average rating of the decision support tool was 7.8 (scale 1 to 10) by participating oncologists and 7.3 by other healthcare providers. Several thresholds for implementation were a negative attitude towards shared decision-making and oncologists’ fixed treatment preferences.

Conclusions: Implementation of our decision support tool succeeded and patient and oncologist satisfaction was above average. Patients’ log in rates differed considerably between participating hospitals while patient online participation was generally high. The most important faced challenge remains to overcome providers’ negative attitude towards shared decision-making.