The Impact of Within-Consultation and Preconsultation Decision Aids for Localized Prostate Cancer on Patient Knowledge: Results of a Patient-Level Randomized Trial.

Autor: Joyce DD; Department of Urology, Mayo Clinic, Rochester, MN., Tilburt JC; Division of General Internal Medicine, Mayo Clinic, Scottsdale, AZ; Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN; Biomedical Ethics Research Program, Mayo Clinic, Rochester, MN. Electronic address: tilburt.jon@mayo.edu., Pacyna JE; Biomedical Ethics Research Program, Mayo Clinic, Rochester, MN., Cina K; Walking Forward Avera Health, Division of Research, Rapid City, SD., Petereit DG; Cancer Care Institute at Monument Health, Rapid City, SD; Walking Forward Avera Health, Division of Research, Rapid City, SD., Koller KR; Alaska Native Tribal Health Consortium Research Services, Anchorage, AK., Flanagan CA; Alaska Native Tribal Health Consortium Research Services, Anchorage, AK; Alaska Native Epidemiology Center, Alaska Native Tribal Health Consortium, Anchorage, AK., Stillwater B; Alaska Native Tribal Health Consortium Research Services, Anchorage, AK., Miller M; Department of Urology, Alaska Native Medical Center, Anchorage, AK., Kaur JS; Department of Hematology and Oncology, Mayo Clinic, Jacksonville, FL., Peil E; Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN., Zahrieh D; Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN., Dueck AC; Clinical Trials and Biostatistics, Mayo Clinic, Scottsdale, AZ., Montori VM; Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN., Frosch DL; Health Science Diligence Advisors, LLC, Redwood City, CA., Volk RJ; Division of Cancer Prevention and Population Sciences, Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX., Kim SP; Division of Urology, University of Colorado Anschutz Medical Center, University of Colorado, Aurora, CO.
Jazyk: angličtina
Zdroj: Urology [Urology] 2023 May; Vol. 175, pp. 90-95. Date of Electronic Publication: 2023 Mar 09.
DOI: 10.1016/j.urology.2023.02.029
Abstrakt: Objective: To evaluate the role of timing (either before or during initial consultation) on the effectiveness of decision aids (DAs) to support shared-decision-making in a minority-enriched sample of patients with localized prostate cancer using a patient-level randomized controlled trial design.
Methods: We conducted a 3-arm, patient-level-randomized trial in urology and radiation oncology practices in Ohio, South Dakota, and Alaska, testing the effect of preconsultation and within-consultation DAs on patient knowledge elements deemed essential to make treatment decisions about localized prostate cancer, all measured immediately following the initial urology consultation using a 12-item Prostate Cancer Treatment Questionnaire (score range 0 [no questions correct] to 1 [all questions correct]), compared to usual care (no DAs).
Results: Between 2017 and 2018, 103 patients-including 16 Black/African American and 17 American Indian or Alaska Native men-were enrolled and randomly assigned to receive usual care (n = 33) or usual care and a DA before (n = 37) or during (n = 33) the consultation. After adjusting for baseline characteristics, there were no statistically significant proportional score differences in patient knowledge between the preconsultation DA arm (0.06 knowledge change, 95% CI -0.02 to 0.12, P = .1) or the within-consultation DA arm (0.04 knowledge change, 95% CI -0.03 to 0.11, P = .3) and usual care.
Conclusion: In this trial oversampling minority men with localized prostate cancer, DAs presented at different times relative to the specialist consultation showed no improvement in patient knowledge above usual care.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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