Decision Support and Shared Decision Making About Active Surveillance Versus Active Treatment Among Men Diagnosed with Low-Risk Prostate Cancer: a Pilot Study

  • Ronald E. Myers
  • Amy E. Leader
  • Jean Hoffman Censits
  • Edouard J. Trabulsi
  • Scott W. Keith
  • Anett M. Petrich
  • Anna M. Quinn
  • Robert B. Den
  • Mark D. Hurwitz
  • Costas D. Lallas
  • Sarah E. Hegarty
  • Adam P. Dicker
  • Charnita M. Zeigler-Johnson
  • Veda N. Giri
  • Hasan Ayaz
  • Leonard G. Gomella
Article

Abstract

This study aimed to explore the effects of a decision support intervention (DSI) and shared decision making (SDM) on knowledge, perceptions about treatment, and treatment choice among men diagnosed with localized low-risk prostate cancer (PCa). At a multidisciplinary clinic visit, 30 consenting men with localized low-risk PCa completed a baseline survey, had a nurse-mediated online DS session to clarify preference for active surveillance (AS) or active treatment (AT), and met with clinicians for SDM. Participants also completed a follow-up survey at 30 days. We assessed change in treatment knowledge, decisional conflict, and perceptions and identified predictors of AS. At follow-up, participants exhibited increased knowledge (p < 0.001), decreased decisional conflict (p < 0.001), and more favorable perceptions of AS (p = 0.001). Furthermore, 25 of the 30 participants (83 %) initiated AS. Increased family and clinician support predicted this choice (p < 0.001). DSI/SDM prepared patients to make an informed decision. Perceived support of the decision facilitated patient choice of AS.

Keywords

Prostate cancer Active surveillance Shared decision making Decision support interventions 

Notes

Acknowledgment

This project was funded, in part, under a grant with the Pennsylvania Department of Health (SAP No. 41000062221). The Department specifically disclaims responsibility for any analyses, interpretations, or conclusions.

Compliance with Ethical Standards

This study was approved by the Thomas Jefferson University Institutional Review Board.

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Copyright information

© American Association for Cancer Education 2016

Authors and Affiliations

  • Ronald E. Myers
    • 1
  • Amy E. Leader
    • 1
  • Jean Hoffman Censits
    • 1
  • Edouard J. Trabulsi
    • 2
  • Scott W. Keith
    • 3
  • Anett M. Petrich
    • 1
  • Anna M. Quinn
    • 1
  • Robert B. Den
    • 4
  • Mark D. Hurwitz
    • 4
  • Costas D. Lallas
    • 2
  • Sarah E. Hegarty
    • 3
  • Adam P. Dicker
    • 4
  • Charnita M. Zeigler-Johnson
    • 1
  • Veda N. Giri
    • 1
  • Hasan Ayaz
    • 5
  • Leonard G. Gomella
    • 2
  1. 1.Division of Population Science, Department of Medical OncologySidney Kimmel Medical College, Thomas Jefferson UniversityPhiladelphiaUSA
  2. 2.Department of UrologySidney Kimmel Medical College, Thomas Jefferson UniversityPhiladelphiaUSA
  3. 3.Department of Pharmacology and Experimental TherapeuticsSidney Kimmel Medical College, Thomas Jefferson UniversityPhiladelphiaUSA
  4. 4.Department of Radiation OncologySidney Kimmel Medical College, Thomas Jefferson UniversityPhiladelphiaUSA
  5. 5.School of Biomedical Engineering, Science and Health SystemsDrexel UniversityPhiladelphiaUSA

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