Preferences of bereaved family members on communication with physicians when discontinuing anticancer treatment. - Referring to the concept of nudges

Abstract

Abstract Purpose: This study aimed to clarify the situation and evaluate the communication on anticancer treatment discontinuation from the viewpoint of a bereaved family, in reference to the concept of nudges. Methods: A multi-center questionnaire survey was conducted involving 350 bereaved families of patients with cancer admitted to palliative care units in Japan. Results: The following explanations were rated as essential or very helpful: 1) anticancer treatment would be a physical burden for the patient (43.1%), 2) providing anticancer treatment was impossible (40.6%), 3) the disadvantages of undergoing treatment (40.6%), 4) not having the treatment would be better for the patient (40.6%), and 5) the advantages of not having the treatment (40.3%). The factors associated with a high need for improvement of the physician’s explanation included older age of the participant (β = 0.221, p = 0.010); lack of explanation that anticancer treatment cannot be given (β = 0.219, p = 0.001); and lack of explanation on the specific benefits of not having treatment (β = 0.251, p = 0.001). Conclusion: Explaining the disadvantages of continuing anticancer treatment and the advantages of discontinuing treatment and presenting treatment discontinuation as the default option were effective in helping patients’ families in making the decision to discontinue treatment. In particular, explanation regarding the benefits of treatment discontinuation and show the discontinuation of anticancer treatment as the default option was considered important, as the lack of them caused a higher need for improvement.