Clinical Epidemiology and Ageing

Preferences for surrogate designation and decision-making process in older versus younger adults with cancer: A comparative cross-sectional study.

Martinez-Tapia C, Canoui-Poitrine F, Caillet P, Bastuji-Garin S, Tournigand C, Assaf E, Varnier G, Pamoukdjian F, Brain E, Rollot-Trad F, Laurent M, Paillaud E Patient Educ Couns. 2019;102(3):429-435.

OBJECTIVE: To compare the preferences of older (≥70 years old) versus younger (<70 years old) cancer patients regarding surrogate designation and decision making.

METHODS: A cross-sectional survey. Patient characteristics and information about surrogacy and involvement in decision making were collected. Associations between patient characteristics and preferences were examined.

RESULTS: The study included 130 patients aged ≥70 years (mean age 80 years) and 102 patients aged <70 years (mean age 55) and. Factors independently associated with surrogate knowledge (66%): younger age, more children living nearby, high income; factors associated with having already designated a surrogate (62%): younger age, decreased number of daily medications; factors associated with designating a surrogate after questionnaire administration (40%): low education, metastasis. Patients requiring an informed consent for any intervention was associated with older age (adjusted OR [aOR] = 1.04[95% confidence interval 1.00-1.08]), not living alone (aOR = 2.52[1.00-6.36]), and having children (aOR = 4.49[1.13-17.81]).

CONCLUSION: All cancer patients, wanted to be fully informed and 72% wanted to be involved in medical decisions. Preferences for decision control vary between age groups, depending on family members' presence and living alone.

PRACTICE IMPLICATIONS: Sharing complete and clear information should be an important key in the process of cancer patients' care, regardless of patient age.

MeSH terms: Adult; Aged; Aged, 80 and over; Cross-Sectional Studies; Decision Making; Female; Health Knowledge, Attitudes, Practice; Health Literacy; Humans; Informed Consent; Male; Middle Aged; Neoplasms; Patient Education as Topic; Patient Participation; Patient Preference; Proxy
DOI: 10.1016/j.pec.2018.09.024