Patient–physician interactions during early breast-cancer treatment: results from an international online survey

ABSTRACT

Objective: To examine, via an international survey, the impact of positive and negative interactions on the patient–physician relationship.

Research design and methods: This online survey was conducted in five countries (USA, UK, Germany, Italy and France) in two populations: (1) postmenopausal women diagnosed with early breast cancer (EBC) in the past 5 years, who had undergone surgery; (2) breast-cancer physicians. The survey covered several topics: patient–physician interactions, EBC treatment options and sources of information.

Results: In total, 462 physicians and 600 patients responded. Most (85%) physicians considered having a good relationship with their patient the most rewarding part of their job. Although 60% of physicians were satisfied with the consultation time (average 17.9 min), 30% considered it insufficient, whilst 49% of patients would prefer more time. Patients reported that physicians were a primary source of information, with 81% indicating that trust in their physician was a vital component of their care. Many physicians (63%) felt that patients are overwhelmed by the amount of information available, but only 16% of patients felt overwhelmed. Most physicians (78%) consider that telling a patient she has EBC is easier than talking about recurrence; 44% rated talking about recurrence as the most stressful part of their job. Most physicians (91%) considered availability of clinical trial data to be crucial for building trust and 74% believed that treatments that minimise recurrence enable more positive conversations.

Conclusions: Good-quality patient care extends beyond effective treatment to include good communication about therapeutic options, side effects, and the development of trust and confidence. The survey revealed some disparities in physicians' and patients' views, but demonstrated that a strong patient–physician relationship is highly valued by both. Patients need access to accurate information and adequate consultation time. Providing effective and well-tolerated treatments that minimise recurrence may help promote positive interactions.

Key words: :

• Aromatase inhibitors
• Breast cancer
• Patient–physician relationship
• Survey

Acknowledgements

Declaration of interest: We thank all the patients and physicians who participated in the survey. Dr Lansdown has received travel grants and honoraria from AstraZeneca, Novartis and Pfizer. Dr Martin has received travel grants and honoraria from AstraZeneca, Novartis, Roche and Pfizer. Professor Fallowfield has received honoraria and unrestricted educational grants from AstraZeneca, Novartis and Pfizer. All three authors participated in the design of the survey and the interpretation of the data, and had significant input during the preparation of this manuscript. The sponsor, AstraZeneca Pharmaceuticals, provided financial support for the conduct of the survey, data collection and analysis. The authors would like to thank Sandra Cuscó PhD, from Complete Medical Communications, who provided medical writing support funded by AstraZeneca.