OBJECTIVES:

To identify the characteristics of feeding options that may influence the decision-making process of switching from oral to enteral tube feeding (ETF) and that should be included in a Patient Decision Aid to achieve shared decision making.

METHODS:

A systematic search regarding to studies of patients’ and surrogate decision-makers’ perceptions for ETF nutrition was performed in Medline, Cochrane Library and ISI-WOK. European and North-American studies including original articles, reviews, and congress communications, published in English or Spanish between January 1st 2005 and June 6th 2016, were selected. The quality of these studies was assessed using Oxford Centre for Evidence-based Medicine levels of evidence.

RESULTS:

Of the 742 publications identified in the literature search, 7 were included (1 systematic review, 5 original articles and 1 congress communication). Thirteen items which may potentially influence the decision-making process of switching to ETF were identified. Eight characteristics: loss of food tasting, loss of life normality, loss of independence, loss of social role, feeling of blame and concerning about permanent loss of ability to eat, perceived loss of dignity and loss of quality of life, are perceived by the decision makers as disadvantages of ETF and could hamper the decision to start ETF. Three items: less time needed for feeding, best caloric control and longer overall survival are perceived as benefits of ETF and could promote its implantation. Two additional items have an unclear outcome in the decision-making process: potential feeding complications and patient-caregiver relationship during feeding, that represents an emotional connection between them but as well a stressful situation.

CONCLUSIONS:

Most of the potential factors identified are perceived as disadvantages, which may contribute to delay the switch to ETF. These results highlight the need to develop a decision aid tool aimed to clarify these aspects and facilitate the decision-making process.