Differences in treatment choices between prostate cancer patients using a decision aid and patients receiving care as usual: results from a randomized controlled trial

Objective To determine whether or not decision aid (DA) use influences treatment decisions in patients with low and intermediate risk prostate cancer (PC). Patients and methods In a cluster randomized controlled trial, patients were randomized to either DA use (DA group) or no DA use (control group)...

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Bibliographic Details
Published in:World journal of urology 2021-12, Vol.39 (12), p.4327-4333
Main Authors: Lamers, Romy E. D., Cuypers, Maarten, de Vries, Marieke, van de Poll-Franse, Lonneke V., Bosch, J. L. H. Ruud, Kil, Paul J. M.
Format: Article
Language:English
Subjects:
Aged
Brachytherapy
Cancer surgery
Clinical decision making
Clinical trials
Decision Making
Decision Support Techniques
Humans
Male
Medicine
Medicine & Public Health
Middle Aged
Nephrology
Oncology
Original
Original Article
Patient Preference
Patients
Prostate cancer
Prostatectomy
Prostatic Neoplasms - psychology
Prostatic Neoplasms - therapy
Radiation therapy
Risk Assessment
Urological surgery
Urology
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Summary:Objective To determine whether or not decision aid (DA) use influences treatment decisions in patients with low and intermediate risk prostate cancer (PC). Patients and methods In a cluster randomized controlled trial, patients were randomized to either DA use (DA group) or no DA use (control group). Between 2014 and 2016, newly diagnosed patients with low or intermediate risk PC were recruited in 18 hospitals in the Netherlands. DA users had access to a web-based DA that provided general PC information, PC-treatment information, and values clarification exercises to elicit personal preferences towards the treatment options. Control group patients received care as usual. Differences in treatment choice were analysed using multilevel logistic regressions. Differences in eligible treatment options between groups were compared using Pearson Chi-square tests. Results Informed consent was given by 382 patients (DA group N  = 273, control group N  = 109). Questionnaire response rate was 88% ( N  = 336). Active surveillance (AS) was an option for 38%, radical prostatectomy (RP) for 98%, external beam radiotherapy (EBRT) for 88%, and brachytherapy (BT) for 79% of patients. DA users received AS significantly more often than control group. Patients (29 vs 16%, p  = 0.01), whereas the latter more often chose BT (29 vs 18%, p  
ISSN:0724-4983
1433-8726
DOI:10.1007/s00345-021-03782-7