Predicting decline in functionality and chemotherapy toxicity: A prospective multicentre study

The highest preference for milder treatment options was found amongst Spanish respondents, and this was higher than for England (p=0.005). Swedish respondents were less likely to prefer milder treatments than those in England (p=0.013) (Fig. 4). Overall, the majority of respondents agreed that they would expect to be offered the same treatment choices as younger patients. Again, this proportion was highest in England. There was also, however, a strong preference for letting the doctor make decisions on the patient's behalf: some three-quarters of English respondents indicated agreement, as did the majority of those in other countries. Conclusions: The results indicate the level of acceptance of risk in choice of treatment amongst older people in the countries surveyed. Respondents in England were particularly likely to accept more aggressive options. Against this background, there was a high level of trust in doctors to make decisions on patients' behalf. Such trust clearly needs to be reflected in doctors' understanding of patient preferences and appetite for risk. In particular, matching treatment options to individual patient preferences is likely to be important in meeting patient expectations. These findings will be further investigated through in-depth qualitative interviews with older people with cancer in the UK. References [1] Centre for Policy on Ageing (CPA). Ageism and age discrimination in secondary health care in the United Kingdom. CPA; 2009. [2] National Cancer Equality Initiative and the Pharmaceutical Oncology Initiative (NCIN). The impact of patient age on clinical decision making in oncology. Department of Health; 2012.