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Effects of a Computerized System to Support Shared Decision Making in Symptom Management of Cancer Patients: Preliminary Results

Affiliations of the authors: Rikshospitalet National Hospital, Oslo, Norway (CMR, SMK); Columbia University, New York, New York (CMR, TW); DH Medical Center, Lebanon, New Hampshire (CMR, MS, GF), USA

Correspondence and reprints: Cornelia M. Ruland, RN, PhD, Center for Shared Decision Making & Nursing Research, Rikshospitalet National University Hospital, Forskningsvn. 2b, N- 0027 Oslo, Norway; e-mail: <cornelia.ruland{at}rikshospitalet.no>.

Received for publication: 03/16/03; accepted for publication: 07/14/03.

Objective: (1) To evaluate preliminary effects of a computerized support system on congruence between patients' reported symptoms and preferences and those addressed in the patient consultation and (2) to investigate the system's ease of use, time requirements, and patient satisfaction.

Design: Fifty-two patients were randomly assigned to intervention or control conditions.

Measurements: Cancer patients scheduled for an outpatient visit used the system on a tablet computer to report their symptoms and preferences prior to their consultation. This information was processed, printed, and provided to the patient and clinician in the subsequent consultation in the experimental group but not in the control group.

Results: While patients in both groups were equivalent at baseline in symptom characteristics, there was significantly greater congruence between patients' reported symptoms and those addressed by their clinicians in the experimental group. The system scored high on ease of use. There were no significant group differences in patient satisfaction.

Conclusion: This study provided beginning evidence that eliciting patients' symptoms and preferences and providing clinicians with this information prior to consultation can be an effective and feasible strategy to improve patient-centered care.

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