eP359 - Development of a Priorities Assessment Tool to Support Shared Decision Making in Rectal Cancer Patients Undergoing Restorative Proctectomy

Purpose/Background: Proper two-way communication with rectal cancer patients and their physicians is an essential element in determining treatment course and satisfaction with care. However, patients may experience difficulty discussing treatment goals, priorities, and quality-of-life concerns with their physician, often due to insufficient consultation time. Therefore, the objective of this study is to develop a patient-centered priorities assessment tool for patients with mid and low rectal cancer to help prioritize their personal preferences, goals of treatment, enhance communication and increase patient satisfaction.Methods/Interventions: This was a prospective study performed at a single academic specialist rectal cancer center. We designed a 11-item index priorities assessment tool (PAT) using a validated rectal cancer symptom index derived from patient responses of the Patient-Generated Index (PGI) from a previous study at our institution to assess daily health-related quality-of-life priorities (Appendix I). The PAT was used to measure how important the items are in the patient's decision-making process and to what extent it influences their decision. Validity and feasibility of the PAT was then assessed by administering it to rectal cancer patients who finished treatment during their cancer surveillance clinic visits. All adult patients with rectal adenocarcinoma (defined as tumor less than 15 cm from the anal verge) who had completed treatment including definitive chemoradiation, local excision, and radical proctectomy with primary anastomosis (i.e., TME) of any approach and who have undergone restoration of bowel continuity at ≥1 year were eligible for this study. The tool was used to ask participants to rate the importance of 11 potential daily quality-of-life priorities (e.g., My physical appearances, having regular and predictable bowel movements, my sleep, my ability to continue performing my usual and normal physical activities etc.) and participants were asked to mark their top 5 priorities among the 11 potential daily quality-of-life priorities. This was followed by a post-activity feedback form that was used to assess patient experience with the priorities assessment tool.Results/Outcomes: In this preliminary analysis, 8 patients completed the priorities assessment tool and the post activity feedback form between September 2023 to October 2023. All participants reported that the tool captured their preferences, values and was easy to complete and understand. All eight participants (100%) completed the tool in 5 minutes or less. All participants (n = 8, 100%) were able to stratify their priorities and identify 5 top treatment-related priorities and also reported that the tool helped in identifying current goals and priorities. Almost all (7/8, 88%) participants reported that the tool helped them feel more comfortable participating in shared decision making with their medical team.Conclusion/

Discussion: The rectal cancer patient-centered priorities assessment tool was easy to complete and helped patients in prioritizing their personal preferences and goals of treatment. The use of a priorities assessment tool among rectal cancer patients has the potential to improve patient satisfaction, communication and encourage shared decision making. This study data should help achieve optimal patient-centered care delivery in the management of rectal cancer.APPENDIX I – Priorities Assessment ToolHere is a list of statements about your personal preferences and goals when considering treatment for rectal cancer. How important are the following factors in your decision-making process and to what extent do the following factors influence your decision. Please indicate and rate your top 5 priorities (1 being more important, 5 being less important) on how important each issue is to you as it applies today. In addition, circle One number on Each Line