Mariken Stegmann

Comparison with existing literature  Other studies using the same questionnaire have described comparably high mean  scores, 22,37,38  indicating that patients might generally be confident in their ability to  participate in shared decision making. 39  It may also be that the outcome measure is not  robust enough. Finding robust outcome measures has proven to be a problem in research on  improving health care. 40  Any healthcare provider can use the OPT, but the authors deliberately chose the GP  because of their often longstanding relationship with older patients. Interestingly, one‐third  of the GPs reported that they still gained new insights about the treatment goals of their  patients during the conversations, consistent with earlier research showing that healthcare  providers often incorrectly assume their patients’ priorities. 8  GPs also reported that the OPT  helped them to start a conversation about advance care planning. This is particularly  important because research indicates that most patients would not only like to talk with  their GP about this topic but also that they would like GPs to take the initiative. 41 It has been argued that GPs lack the expertise to discuss different treatment options and  could increase confusion and anxiety. 36  However, treatment options are irrelevant to the  OPT‐facilitated conversation, which only considers the generic goals of patients. Moreover,  in the present study sample, the OPT‐ facilitated conversation was associated with  statistically significant lower anxiety compared with care as usual.  Implications for research and practice  In conclusion, the results presented here indicate that an OPT‐facilitated conversation with a  GP about generic treatment goals may lead to less anxiety and fatigue. This conversation  might affect empowerment for subgroups of patients with low baseline empowerment  scores, yet the present results remain inconclusive. Further research is needed into the  effect of these conversations, but in view of the positive evaluations, healthcare providers  might consider adding the OPT to facilitate conversations that seek to improve patient‐  tailored care.  Additional information  Funding  This study was supported by a grant from the Dutch Cancer Society Fund (KWF  Kankerbestrijding) (ref: RUG 2014‐7273). The sponsor had no role in the study design,  collection, analysis, interpretation of data, the writing of the report, or in the decision to  submit the article for publication.  Ethical approval  The trial was assessed by the Medical Ethics Committee of the University Medical Centre  Groningen (ref: 2015/275).  Provenance  Freely submitted; externally peer reviewed.  Competing interests  The authors have declared no competing interests.  4 49 The OPTion randomised controlled trial