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Effectiveness of Decision Aid in Men with Localized Prostate Cancer: a Multicenter Randomized Controlled Trial at Tertiary Referral Hospitals in an Asia Pacific Country

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Abstract

There are several treatment options for localized prostate cancer with very similar outcome but vary in terms of technique and side effect profiles and risks. Considering the potential difficulty in choosing the best treatment, a patient decision aid (PDA) is used to help patients in their decision-making process. However, the use and applicability of PDA in a country in Asia Pacific region like Malaysia is still unknown. This study aims to evaluate the effectiveness of a PDA modified to the local context in improving patients’ knowledge, decisional conflict, and preparation for decision making among men with localized prostate cancer. Sixty patients with localized prostate cancer were randomly assigned to control and intervention groups. A self-administered questionnaire, which evaluate the knowledge on prostate cancer (23 items), decisional conflict (10 items) and preparation for decision-making (10 items), was given to all participants at pre- and post-intervention. Data were analyzed using independent T test and paired T test. The intervention group showed significant improvement in knowledge (p = 0.02) and decisional conflict (p = 0.01) from baseline. However, when compared between the control and intervention groups, there were no significant differences at baseline and post-intervention on knowledge, decisional conflict and preparation for decision-making. A PDA on treatment options of localized prostate cancer modified to the local context in an Asia Pacific country improved patients’ knowledge and decisional conflict but did not have significant impact on the preparation for decision-making. The study was also registered under the Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12614000668606 registered on 25/06/2014.

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Acknowledgements

We would like to acknowledge the Director General of the Ministry of Health, Malaysia, for permission to conduct and publish this study. We also acknowledge the contribution of all the urology nurses who have help in data collection and recruitment. Finally, we would like to thank all the patients who participated in the study and acknowledge the grant from Universiti Putra Malaysia (RUGS 2-2012-2093).

Availability of Data and Material

Available on request from researchers with approval from Unversiti Putra Malaysia.

Funding

Financial support for this study was provided entirely by a grant from University Putra Malaysia. The funding agreement ensured the authors’ independence in designing the study, interpreting the data, writing, and publishing the report.

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Authors and Affiliations

  1. Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia

    N. B. Jalil, P. Y. Lee, F. N. S. Mohd Azizi, N. N. S. Abdul Rassip & A. T. Cheong

  2. Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia

    M. Z. Nor Afiah

  3. Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia

    K. L. Abdullah

  4. Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia

    T. A. Ong & A. H. Razack

  5. Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia

    C. J. Ng & Y. K. Lee

  6. Department of Clinical Oncology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia

    M. Saad & A. Alip

  7. Unit of Urology, Selayang Hospital, Selangor, Malaysia

    R. Malek

  8. Unit of Urology, General Hospital of Kuala Lumpur, Kuala Lumpur, Malaysia

    M. Sundram

  9. Unit of Urology, Johor Bahru Hospital, Johor Bahru, Johor, Malaysia

    S. Omar

  10. Unit of Urology, Penang Hospital, Penang, Malaysia

    J. R. Sathiyananthan

  11. Department of Surgery, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia

    P. Kumar

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  1. N. B. Jalil
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Correspondence to P. Y. Lee.

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Ethics approval was obtained from the Malaysian Ministry of Health Medical Research Ethics Committee (NMRR-14-494-20,143), Medical Research Ethic Committee of University of Malaya (20144-81) and Medical Research Ethic Committee of Universiti Putra Malaysia.

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Jalil, N.B., Lee, P.Y., Nor Afiah, M.Z. et al. Effectiveness of Decision Aid in Men with Localized Prostate Cancer: a Multicenter Randomized Controlled Trial at Tertiary Referral Hospitals in an Asia Pacific Country. J Canc Educ 37, 169–178 (2022). https://doi.org/10.1007/s13187-020-01801-6

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