Treatment advancements in chronic myeloid leukaemia (CML) have made the disease manageable but carry significant risk of side effects. Bridging information gaps between patients and physicians through shared decision-making (SDM) is increasingly favoured, yet understanding treatment complexities remains a challenge. This study sought to identify decisional and informational needs of both patients and physicians in CML care.

A qualitative study using semi-structured interviews was conducted to investigate the opinions, attitudes and preferences of both patients with chronic myeloid leukaemia and physicians.

Patients and physicians were recruited through the Dutch CMyLife platform, an initiative of haematologists, patients and patient organisations. They were provided with the participant information and invited to participate if interested.

A total of 15 interviews (n=10 patients, n=5 physicians) were conducted between April and October 2023.

A pre-defined interview guide was developed based on the Decisional Needs Assessment questionnaire. Interview transcripts were thematically analysed.

Eight themes and 28 sub-themes were observed, highlighting patient needs, treatment choices and informational preferences. Patients emphasised the importance of understanding medication options and side effects, while physicians stressed the necessity of delivering up-to-date and comprehensible information. Almost all participants had experienced professionals making the treatment decision, without patient involvement, especially when initiating treatment. Some patients expressed too little information and missed partnership with professionals at treatment onset. Peer support, decision-making dynamics and the role of caregivers were also significant considerations.

Both shared and distinct perspectives on CML treatment decision-making between patients and physicians were revealed, underscoring the complexity of decisional needs in CML management. The findings emphasise the importance of patient-centred care, SDM and tailored communication strategies to optimise patient outcomes and satisfaction. Improved communication and evidence-based decision-making tools can significantly impact patient well-being. Further research and interventions are necessary to address the challenges in decision-making processes in CML care.

This study explored the knowledge and awareness of Dutch patients, healthcare professionals (HCPs) and healthcare insurers on the climate impact of inhalers as well as (factors influencing) their attitude towards climate-friendly inhaler prescription.

We recruited participants for this qualitative study with purposive sampling. We conducted four online focus groups with patients, six with HCPs and two interviews with healthcare insurer representatives. Determinants were analysed with the Framework Approach.

21 patients, 27 HCPs and two healthcare insurer representatives.

Knowledge and awareness on the climate impact of inhalers varied and was generally lower among patients and healthcare insurers than among HCPs. The attitude towards climate-friendly inhaler prescription was variable among patients and mainly positive among HCPs. Both patients and HCPs assigned a greater role to HCPs than to patients in considering climate impact and agreed that patients’ interest must remain paramount. Factors influencing implementation were mainly related to outcome expectancies, such as expected effect on freedom of choice, expected response of patients and expected effect on patients’ health. The latter is partly influenced by beliefs about different types of inhalers. HCPs expressed a need for information and training on the topic and for collaboration with other stakeholders in the field of pulmonary care. Healthcare insurers assign themselves a role in a more climate-friendly healthcare but are reluctant to direct the preference policy on climate impact.

Both patients and HCPs feel climate-friendly inhaler prescription is important. Implementation can be promoted by enhancing awareness and providing HCPs with information on inhaler climate impact, how to safely practice climate-friendly prescription and how to inform patients about its benefits. Both patients and HCPs emphasise the significance of preserving freedom of choice in prescription and highlight the need for a consensus approach on climate-friendly prescribing endorsed by all pulmonary care stakeholders.