Evaluating the benefits and challenges of using patient preferences as a tool for clinical decision making in oncology MDT meetings within the National Health Service (NHS): A qualitative study.

Abstract

Introduction: Multidisciplinary Team (MDT) oncology meetings foster collaboration among healthcare practitioners to determine the most appropriate course of action for cancer patient care. Defining what is 'best' for a patient is complex, involving clinical guidelines, patient needs, evidence-based practices, and available treatment options. Patient participation offers unique insights into cultural and psycho-social preferences, shifting away from the paternalistic health care model. This study aimed to explore the benefits, barriers, and challenges associated with integrating patient preferences (PPs) into oncology MDT decision making.

Methods: Thirty participants from two major UK oncology centers completed questionnaires, with eight participating in the follow-up interviews.

Results: The key benefits of incorporating patient preferences included improved patient satisfaction, treatment adherence, and decision-making efficiency. The major barriers were lack of clinical information, insufficient knowledge of preferences, and time constraints. Challenges within MDT meetings include poor attendance of key clinicians, inadequate chairing, and physical constraints.

Conclusion: This is the first UK-based study to explore physicians' perspectives on incorporating patient preferences into oncology decision-making. While patient preferences are valued, integration is often hindered by systemic pressure within the NHS. The findings highlight the complex interplay between patient-centered care ideals and practical implementation challenges, suggesting areas for improvement that incorporate patient voices into cancer care decision-making.