Developing a Decision Aid to Support Informed Choices for Newly Diagnosed Patients With Localized Prostate Cancer

For the treatment choice of localized prostate cancer, effective patient decision aids have been developed. The implementation of decision aids in routine care, however, lags behind. Main known barriers are lack of confidence in the tool, lack of training on its use, lack of resources and lack of time. A new implementation strategy addresses these barriers. Using this implementation strategy, the implementation rate of a decision aid was measured in eight hospitals and questionnaires were filled out by 24 care providers and 255 patients. The average implementation rate was 60 per cent (range 31%–100%). Hardly any barriers remained for care providers. Patients who did not use the decision aid appeared to be more unwilling than unable to use the decision aid. By addressing known barriers, that is, informing care providers on the effectiveness of the decision aid, providing instructions on its use, embedding it in the existing workflow and making it available free of charge, a successful implementation of a prostate cancer decision aid was reached.

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683: Race/Ethnicity and Health Literacy Associated Variations in Quality of Life (QOL) Following Treatment for Veterans with Newly Diagnosed Localized Prostate Cancer (PCA)

The Journal of Urology ◽

10.1016/s0022-5347(18)32929-x ◽

2006 ◽

Vol 175 (4S) ◽

pp. 221-221

Author(s):

Jessica A. Zagory ◽

Chih-Hung Chang ◽

Ken Carson ◽

Charles L. Bennett

Keyword(s):

Quality Of Life ◽

Prostate Cancer ◽

Health Literacy ◽

Localized Prostate Cancer ◽

Newly Diagnosed ◽

Race Ethnicity

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11 / A PATIENT DECISION AID FOR MEN WITH LOCALIZED PROSTATE CANCER: A COMPARATIVE CASE STUDY OF NATURAL IMPLEMENTATION APPROACHES

10.26226/morressier.5afadd89f314ac000849afa8 ◽

2018 ◽

Author(s):

Dawn Stacey

Keyword(s):

Prostate Cancer ◽

Decision Aid ◽

Localized Prostate Cancer ◽

Comparative Case Study ◽

Patient Decision Aid ◽

Patient Decision

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Adoption of robot-assisted surgery and its impact on treatment patterns for newly diagnosed localized prostate cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.6513 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. 6513-6513

Author(s):

Ya-Chen T. Shih ◽

Jim C. Hu ◽

Chan Shen ◽

Scott E. Eggener

Keyword(s):

Prostate Cancer ◽

Radiation Therapy ◽

Active Surveillance ◽

State Level ◽

Treatment Patterns ◽

Stage I ◽

Robotic Systems ◽

Localized Prostate Cancer ◽

Newly Diagnosed ◽

Impact On Treatment

6513 Background: With the rapid increase of robotic surgical systems in hospitals, it is important to understand the impact on treatment patterns for localized prostate cancer. The objective of this study is to determine whether the presence of robotic surgical systems independently influenced rates of surgery, radiation, and active surveillance for localized prostate cancer. Methods: We conducted an observational study using National Cancer Database (NCDB) state-level data, 2002-2010. Our study cohort includes patients newly diagnosed with clinical stage I-III prostate cancer from 48 states and Washington D.C. in the United States. The number of robotic systems installed in each state over time was obtained from publicly available information on-line. We characterized the state-level treatment pattern as the proportion of patients having surgery, radiation and active surveillance as their first course of treatment. Results: Between 2002 and 2010, the average number of robotic surgical systems per state increased from 2 to 26.3, while the unadjusted rate of surgery increased from 37.5% to 52.4%, radiation therapy decreased from 43.3% to 30.2%, and active surveillance increased from 7.0% to 9.3%. For every 10 additional robotic systems installed in a state, there would be a 2.5% increased rate of surgery (p<0.01), accompanied by a 1.3% (p=0.04) and 1.0% (p<0.01) decrease in the rate of radiation and active surveillance, respectively. Subgroup analyses suggest that the robotic adoption crowding out effect on radiation and active surveillance was driven primarily by men with stage I-II prostate cancer. If the adoption trajectory for robotic systems continues, the increased cost of treating localized prostate cancer in 2012 will be close to $27 million. Conclusions: During a period of rapid acquisition of robotic surgical systems, we found the number of robotic systems available at the state-level is significantly and directly associated with a higher rate of surgery for localized prostate cancer, and lower rates of radiation therapy and active surveillance.

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