The role of healthcare professionals' attitudes in treatment decision-making for older adults with cancer: A scoping review.

Introduction: The global population of older adults with cancer is increasing, presenting care challenges caused by comorbidity, polypharmacy, and frailty. In response to these complexities, healthcare professionals (HCPs) rely on their own attitudes to a larger extent due to limitations in the treatment evidence for this population. This scoping review aims to explore and describe the attitudes of HCPs in the context of treatment decision-making for older adults with cancer.

Materials and methods: We conducted a scoping review on HCP attitudes or subjective inclinations in the treatment decision-making process for older adults with cancer. PubMed, Embase, Medline, and EBSCO CINAHL Complete were searched using predefined inclusion criteria. A two-step screening process was implemented, conducted by two-reviewer teams.

Results: From 5161 de-duplicated references, 21 studies were retained for analysis (nine qualitative, six quantitative, five mixed methods). Five patterns were observed, highlighting how HCP attitudes can shape consultation dynamics, influence the interpretation of patient factors such as age and comorbidities, and impact communication with older patients. Additionally, HCP background profession and practice environment emerged as influential in shaping both attitudes and decision-making processes.

Discussion: This scoping review describes the role of HCP attitudes in communicating treatment options with older adults with cancer. It suggests the importance of considering the role of attitudes in decision-making when developing educational resources for geriatric-centred communication skills to support shared decision-making practices in the cancer treatment of older adults.