Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2019

Barriers and facilitators of implementing a web-based infertility risk prediction tool (FoRECAsT) for young breast cancer patients into clinical practice. (#51)

Zobaida Edib 1 2 , Yasmin Jayasinghe 1 2 3 , Martha Hickey 1 2 , Alexandra Gorelik 4 5 , Christobel Saunders 6 , Shanton Chang 7 , Patrick Pang 7 , Kate Stern 8 9 , Michelle Peate 1 2
  1. Department of Obstetrics and Gynaecology, The Royal Women's Hospital, Parkville, Victoria, Australia
  2. University of Melbourne, Parkville, VICTORIA, Australia
  3. The Royal Children's Hospital, Parkville, Victoria, Australia
  4. Department of Medicine, The Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia
  5. School of Behavioural & Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia
  6. Faculty of Health and Medical Sciences, Surgery, University of Western Australia, Western Australia, Australia
  7. School of Computing and Information Systems, University of Melbourne, Parkville, Victoria, Australia
  8. Melbourne IVF, Melbourne, Victoria, Australia
  9. Fertility Preservation Service, The Royal Women's Hospital, Parkville, Victoria, Australia

Aim: Current tools to predict fertility outcomes after breast cancer treatments are imprecise and do not offer individualised predictions. To address the gap we are developing a novel web-based infertility risk prediction tool (FoRECAsT) for young breast cancer patients. The aim of this study is to identify the barriers and facilitators for patients and health care providers in implementing the FoRECAsT tool into clinical practice

Methods: A purposive sample of 12 breast cancer patients, 6 breast surgeons, 9 medical oncologists, 9 fertility specialists, 12 breast care nurses and 2 fertility preservation nurses participated in semi-structured in-depth telephone interviews. A constant comparison thematic approach was used to analyse the interviews.

Results: Data were categorized into five main themes: interest in using the FoRECAsT tool; user attributes; access and confidentiality; impact on consultation; and anticipated fertility-related outcomes. A total of fourteen sub-themes emerged. Patients’ identified a need for information regarding post-treatment fertility outcomes. Clinicians and patients both indicated that a comprehensive web-based tool that provided an accurate prognostication about the risk of future infertility would facilitate the use of the tool in clinical practice and result in better management of expectations. The clinical use of the tool would ultimately help patients to make a good quality fertility preservation decisions and be supportive in principle. Barriers included the challenges in inputting clinical data that would be collected at a different time in the treatment process, the responsibilities of clinicians and patients in using the tool, and where and when the tool might be used in the treatment trajectory.

Conclusion: Designing the FoRECAsT tool in consultation with patients and clinicians increases the likelihood that it will be used in clinical practice. Design considerations include taking into account the facilitators and barriers identified in this study.