A Decision Aid to Support Informed Choices for Patients Recently Diagnosed With Prostate Cancer

Chabrera, Carolina; Zabalegui, Adelaida; Bonet, Marta; Caro, M.; Areal, J.; González, Juan R.; Font, Albert

doi:10.1097/ncc.0000000000000170

Cited by 52 publications

(20 citation statements)

References 46 publications

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“… Decisional self-efficacy increased in both groups but was higher in the intervention group ( p = 0.011) Scores on decisional conflict were lower in the intervention group ( p = 0.047) b Control group: surgery [ 22 ], external beam radiotherapy [ 17 ], hormone therapy [ 2 ], brachytherapy [ 2 ], active monitoring [ 14 ] Intervention group: surgery [ 17 ], external beam radiotherapy [ 11 ], hormone therapy [ 5 ], brachytherapy [ 5 ], active monitoring [ 9 ] Lower in intervention group at 6-month follow-up ( p = 0.036) No significant difference between groups was found for mental adjustment to cancer, anxiety or depression n.a. Chabrera, 2015 [ 31 ] Men in the intervention group scored significantly higher on knowledge after DA use compared with the control group ( p < 0.001) n.a. Patients in the intervention group had lower decisional conflict scores ( p < 0.001) n.a.…”

Section: Resultsmentioning

confidence: 99%

“…These DAs included written information, videos and/ or exercises offering patients the opportunity to consider what they deemed important regarding the treatment choice of their disease. Six studies used an informational booklet, containing information on the disease, different treatment options and the possible side effects of each treatment option [26,31,32,[38][39][40]. In four studies, a video presentation was the main tool of the DA [32,34,36,41].…”

Section: Type Of Interventionmentioning

confidence: 99%

“…In five studies, the DA primarily involved an additional consultation with an expert [25,30,37,43,44]. Three studies explicitly mentioned the added value of clarification exercises to the DA [29,31,42]. Please note that some studies did not use only one type of intervention, but a combination of, for example, an information booklet and a web-based DA.…”

Section: Type Of Interventionmentioning

confidence: 99%

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Interventions that Facilitate Shared Decision-Making in Cancers with Active Surveillance as Treatment Option: a Systematic Review of Literature

et al. 2020

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Purpose of review Medical decisions concerning active surveillance are complex, especially when evidence on superiority of one of the treatments is lacking. Decision aids have been developed to facilitate shared decision-making on whether to pursue an active surveillance strategy. However, it is unclear how these decision aids are designed and which outcomes are considered relevant. The purpose of this study is to systematically review all decision aids in the field of oncological active surveillance strategies and outcomes used by authors to assess their efficacy. Recent findings A search was performed in Embase, Medline, Web of Science, Cochrane, PsycINFO Ovid and Google Scholar until June 2019. Eligible studies concerned interventions aiming to facilitate shared decision-making for patients confronted with several treatment alternatives, with active surveillance being one of the treatment alternatives. Twenty-three eligible articles were included. Twenty-one articles included patients with prostate cancer, one with thyroid cancer and one with ovarian cancer. Interventions mostly consisted of an interactive web-based decision aid format. After categorization of outcomes, seven main groups were identified: knowledge, involvement in decision-making, decisional conflict, treatment preference, decision regret, anxiety and health-related outcomes. Summary Although active surveillance has been implemented for several malignancies, interventions that facilitate shared decision-making between active surveillance and other equally effective treatment alternatives are scarce. Future research should focus on developing interventions for malignancies like rectal cancer and oesophageal cancer as well. The efficacy of interventions is mostly assessed using short-term outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Type Of Interventionmentioning

confidence: 99%

Section: Type Of Interventionmentioning

confidence: 99%

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Interventions that Facilitate Shared Decision-Making in Cancers with Active Surveillance as Treatment Option: a Systematic Review of Literature

et al. 2020

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“…Findings across studies testing prostate cancer decision aids with patients have varied, but generally the overall pattern of results are similar to previous work described above in regards to decision aids in general [ 10 ]. Specifically, patients who received a decision aid were slightly more knowledgeable [ 11 , 12 ], more satisfied with their decision [ 11 , 13 ], and had lower decisional conflict (though several studies show no impact on decisional conflict, results were inconsistent) [ 11 , 13 – 15 ]. The two studies that compared decision aids (as we do in the current study) did not show any differences in decisional conflict [ 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

Head to head randomized trial of two decision aids for prostate cancer

Fagerlin

Holmes‐Rovner

Hofer

et al. 2021

BMC Med Inform Decis Mak

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Background While many studies have tested the impact of a decision aid (DA) compared to not receiving any DA, far fewer have tested how different types of DAs affect key outcomes such as treatment choice, patient–provider communication, or decision process/satisfaction. This study tested the impact of a complex medical oriented DA compared to a more simplistic decision aid designed to encourage shared decision making in men with clinically localized prostate cancer. Methods 1028 men at 4 VA hospitals were recruited after a scheduled prostate biopsy. Participants completed baseline measures and were randomized to receive either a simple or complex DA. Participants were men with clinically localized cancer (N = 285) by biopsy and who completed a baseline survey. Survey measures: baseline (biopsy); immediately prior to seeing the physician for biopsy results (pre- encounter); one week following the physician visit (post-encounter). Outcome measures included treatment preference and treatment received, knowledge, preference for shared decision making, decision making process, and patients’ use and satisfaction with the DA. Results Participants who received the simple DA had greater interest in shared decision making after reading the DA (p = 0.03), found the DA more helpful (p’s < 0.01) and were more likely to be considering watchful waiting (p = 0.03) compared to those receiving the complex DA at Time 2. While these differences were present before patients saw their urologists, there was no difference between groups in the treatment patients received. Conclusions The simple DA led to increased desire for shared decision making and for less aggressive treatment. However, these differences disappeared following the physician visit, which appeared to change patients’ treatment preferences. Trial registration This trial was pre-registered prior to recruitment of participants.

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“…Researchers who performed a systematic review recommended a combination of verbal and written information to patients and their caregivers for standardized care information and to increase knowledge and satisfaction (Johnson & Sandford, 2005). In addition, patients may neglect or misunderstand verbal information, so written aids provide continuous reinforcement and increase knowledge retention because patients can read leaflets or booklets again at home and discuss them with relatives or friends (Boundouki, Humphris, & Field, 2004;Chabrera et al, 2015).…”

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confidence: 99%

Written Information Improves Patient Knowledge About Implanted Ports

Piredda

Migliozzi

Biagioli

et al. 2016

CJON

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The sample included 129 patients; 49% were male, with a mean age of 59 years. Most patients want to receive as much information as possible, preferably before the port is implanted. However, 43% of patients reported they had received little information about ports. After reading the booklet, patients' knowledge, which was measured with a validated seven-item instrument, improved from T0 to T1 (p < 0.001, effect size = 0.689). Oncology nurses, by providing written and verbal information, can increase patients' knowledge about implanted ports and their confidence in caring for their ports.

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A Decision Aid to Support Informed Choices for Patients Recently Diagnosed With Prostate Cancer

Abstract: Decision aid represents a rather innovative approach for a health insurance fund to develop and offer this format of information and decision support. This opens a new field of study for nurses to empower patients in the decision-making process and develop new roles in this area.

Cited by 52 publications

References 46 publications

Interventions that Facilitate Shared Decision-Making in Cancers with Active Surveillance as Treatment Option: a Systematic Review of Literature

Interventions that Facilitate Shared Decision-Making in Cancers with Active Surveillance as Treatment Option: a Systematic Review of Literature

Head to head randomized trial of two decision aids for prostate cancer

Written Information Improves Patient Knowledge About Implanted Ports

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