scholarly journals Patient-Centered Approach to Develop the Patient’s Preferences for Prostate Cancer Care (PreProCare) Tool

2019 ◽  
Vol 4 (1) ◽  
pp. 238146831985537 ◽  
Author(s):  
Ravishankar Jayadevappa ◽  
Sumedha Chhatre ◽  
Joseph J. Gallo ◽  
S. Bruce Malkowicz ◽  
J. Sanford Schwartz ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Decision Making ◽  
Focus Groups ◽  
Cancer Patients ◽  
Cancer Care ◽  
Assessment Tool ◽  
Preference Assessment ◽  
Localized Prostate Cancer ◽  
Advisory Group ◽  
Patient Centered

Objectives. To describe the development of our Patient Preferences for Prostate Cancer Care (PreProCare) tool to aid patient-centered treatment decision among localized prostate cancer patients. Methods. We incorporated patient and provider experiences to develop a patient preference elicitation tool using adaptive conjoint analysis. Our patient-centered approach used systematic literature review, semistructured patient interviews, and provider focus groups to determine the treatment attributes most important for decision making. The resulting computer-based PreProCare tool was pilot tested in a clinical setting. Results. A systematic review of 56 articles published between 1995 and 2015 yielded survival, cancer recurrence, side effects, and complications as attributes of treatment options. We conducted one-on-one interviews with 50 prostate cancer survivors and 5 focus groups of providers. Patients reported anxiety, depression, treatment specifics, and caregiver burden as important for decision making. Providers identified clinical characteristics as important attribute. Input from stakeholders’ advisory group, physicians, and researchers helped finalize 15 attributes for our PreProCare preference assessment tool. Conclusion. The PreProCare tool was developed using a patient-centered approach and may be a feasible and acceptable preference clarification intervention for localized prostate cancer patients. The PreProCare tool may translate into higher participant engagement and self-efficacy, consistent with patients’ personal values.

scholarly journals Sources of Information for Learning and Decision-Making in Men With Localized Prostate Cancer

2020 ◽  
Vol 14 (5) ◽  
pp. 155798832094546 ◽  
Author(s):  
Sumedha Chhatre ◽  
Marsha N. Wittink ◽  
Joseph J. Gallo ◽  
Ravishankar Jayadevappa
Keyword(s):  
Prostate Cancer ◽  
Health Care ◽  
Decision Making ◽  
Cancer Patients ◽  
Information Seeking ◽  
Localized Prostate Cancer ◽  
Care Providers ◽  
Sources Of Information ◽  
Patient Centered ◽  
Information Carrier

Information seeking is essential for effective patient-centered decision-making. However, prostate cancer patients report a gap between information needed and information received. The importance of different information sources for treatment decision remains unclear. Thus, using the Comprehensive Model of Health Information (CMIS) framework, we assessed the antecedent factors, information carrier factors, and information-seeking activities in localized prostate cancer patients. Data were collected via semistructured one-on-one, interviews and structured survey. Men with localized prostate cancer were recruited from two urban health-care centers. Following the interview, participants completed a survey about sources that were helpful in learning about prostate cancer treatment and decision-making. The interviews were audio-recorded, transcribed, and subjected to a thematic analysis using NVivo 10. Fifty localized prostate cancer survivors completed the interviews and surveys. Important antecedent factors that were observed were age, marital status, uncertainty, anxiety, caregiver burden, and out-of-pocket expenses. We identified complexity, magnitude, and reliability as information carrier characteristics. Preferred sources for information were health providers, medical websites, and pamphlets from the doctor’s office. These sources were also perceived as most helpful for decision-making. Urologists, urological oncologists, and radiation/radiation oncologists were important sources of information and helpful in decision-making. Prostate cancer patients obtained information from multiple sources. Most prostate cancer patients make patient-centered choices by incorporating personal factors and medical information. By considering factors that influence patients’ treatment decisions, health-care providers can enhance the patient-centeredness of care. Multiple strategies and interventions are necessary for disseminating valid, reliable, and unbiased information to prostate cancer patients to facilitate informed decisions.

Associations between patient knowledge of others' experiences and treatment choice in men with localized prostate cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 6578-6578
Author(s):  
Aaron J. Katz ◽  
Ying Cao ◽  
Xinglei Shen ◽  
Deborah Usinger ◽  
Sarah Walden ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Decision Making ◽  
North Carolina ◽  
Cancer Patients ◽  
Treatment Options ◽  
Population Based ◽  
Treatment Choice ◽  
Localized Prostate Cancer ◽  
The North ◽  
Patient Reported

6578 Background: Men with localized prostate cancer must select from multiple treatment options, without one clear best choice. Consequently, personal factors, such as knowing other prostate cancer patients who have undergone treatment, may influence patient decision-making. However, associations between knowledge about others’ experiences and treatment decision-making among localized prostate cancer patients has not been well characterized. We used data from a population-based cohort of localized prostate cancer patients to examine whether patient-reported knowledge of others’ experiences is associated with treatment choice. Methods: The North Carolina Prostate Cancer Comparative Effectiveness & Survivorship Study (NC ProCESS) is a population-based cohort of localized prostate cancer patients enrolled from 2011-2013 throughout the state of North Carolina in collaboration with the North Carolina Central Cancer Registry. All patients were enrolled prior to treatment and followed prospectively. Patient decision-making factors including knowledge of others’ experiences with prostate cancer treatment options were collected through patient report. Patient treatment choice was determined through medical record abstraction and cancer registry data. Results: Among 1,202 patients, 17% reported knowing someone who pursued active surveillance (AS) while 28%, 46%, and 59% reported knowing someone who received brachytherapy, external beam radiation (EBRT), or radical prostatectomy (RP), respectively; 26% underwent AS, 9% brachytherapy, 21% EBRT, and 39% RP as their initial treatment. In unadjusted analyses, patients with knowledge of others’ experiences with brachytherapy, EBRT or RP had more than twice the odds of receiving that treatment compared to patients who did not. Knowledge of others’ experience with AS was not associated with choice to undergo AS. Multivariable analysis adjusting for age, race, risk group, and patient-reported goals of care showed knowledge of others’ experiences with brachytherapy (OR 4.60, 95% confidence interval [CI] 2.76 to 7.68), EBRT (OR 2.38, 95% CI 1.69 to 3.34), or RP (OR 4.02, 95% CI 2.84 to 5.70) was significantly associated with odds of receiving that treatment. The odds of receiving a particular treatment option were further increased among patients who reported knowing someone who had a “good” experience with the treatment in question. Conclusions: This is the first population-based study to directly demonstrate the impact of a patient’s knowledge of others’ experiences on treatment choice in prostate cancer. These data provide a new consideration to clinicians in their counseling of patients with newly diagnosed prostate cancer, and also impacts research into the informed decision-making process for this disease.

scholarly journals Design and feasibility of integrating personalized PRO dashboards into prostate cancer care

2015 ◽  
Vol 23 (1) ◽  
pp. 38-47 ◽  
Author(s):  
Andrea L Hartzler ◽  
Jason P Izard ◽  
Bruce L Dalkin ◽  
Sean P Mikles ◽  
John L Gore
Keyword(s):  
Prostate Cancer ◽  
Focus Groups ◽  
Cancer Care ◽  
Line Graphs ◽  
Patient Centered ◽  
Human Centered Design ◽  
Patient Reported ◽  
Related Quality ◽  
Centered Care ◽  
Health Related

Abstract Objective Patient-reported outcomes (PROs) are a valued source of health information, but prior work focuses largely on data capture without guidance on visual displays that promote effective PRO use in patient-centered care. We engaged patients, providers, and design experts in human-centered design of “PRO dashboards” that illustrate trends in health-related quality of life (HRQOL) reported by patients following prostate cancer treatment. Materials and Methods We designed and assessed the feasibility of integrating dashboards into care in 3 steps: (1) capture PRO needs of patients and providers through focus groups and interviews; (2) iteratively build and refine a prototype dashboard; and (3) pilot test dashboards with patients and their provider during follow-up care. Results Focus groups ( n = 60 patients) prioritized needs for dashboards that compared longitudinal trends in patients’ HRQOL with “men like me.” Of the candidate dashboard designs, 50 patients and 50 providers rated pictographs less helpful than bar charts, line graphs, or tables ( P < .001) and preferred bar charts and line graphs most. Given these needs and the design recommendations from our Patient Advisory Board ( n = 7) and design experts ( n = 7), we built and refined a prototype that charts patients’ HRQOL compared with age- and treatment-matched patients in personalized dashboards. Pilot testing dashboard use ( n = 12 patients) improved compliance with quality indicators for prostate cancer care ( P < .01). Conclusion PRO dashboards are a promising approach for integrating patient-generated data into prostate cancer care. Informed by human-centered design principles, this work establishes guidance on dashboard content, tailoring, and clinical use that patients and providers find meaningful.

scholarly journals Factors underlying treatment decision-making for localized prostate cancer in the U.S. and Canada: A scoping review using principal component analysis

2018 ◽  
Vol 13 (7) ◽  
Author(s):  
Mustafa Andkhoie ◽  
Desneige Meyer ◽  
Michael Szafron
Keyword(s):  
Prostate Cancer ◽  
Decision Making ◽  
Principal Component Analysis ◽  
Scoping Review ◽  
Principal Component ◽  
Treatment Decision ◽  
Localized Prostate Cancer ◽  
Key Factors ◽  
Treatment Decision Making ◽  
Word Cloud

Introduction: The purpose of this research is to gather, collate, and identify key factors commonly studied in localized prostate cancer (LPC) treatment decision-making in Canada and the U.S.Methods: This scoping review uses five databases (Medline, EMBASE, CINAHL, AMED, and PsycInfo) to identify relevant articles using a list of inclusion and exclusion criteria applied by two reviewers. A list of topics describing the themes of the articles was extracted and key factors were identified using principal component analysis (PCA). A word cloud of titles and abstracts of the relevant articles was created to identify complementary results to the PCA.Results: This review identified 77 relevant articles describing 32 topics related to LPC treatment decision-making. The PCA grouped these 32 topics into five key factors commonly studied in LPC treatment decision-making: 1) treatment type; 2) socioeconomic/demographic characteristics; 3) personal reasons for treatment choice; 4) psychology of treatment decision experience; and 5) level of involvement in the decision-making process. The word cloud identified common phrases that were complementary to the factors identified through the PCA.Conclusions: This research identifies several possible factors impacting LPC treatment decision-making. Further research needs to be completed to determine the impact that these factors have in the LPC treatment decision-making experience.

scholarly journals PD40-07 ADDRESSING HEALTH LITERACY IMPROVES SHARED DECISION MAKING IN UNDERSERVED AFRICAN AMERICAN PROSTATE CANCER PATIENTS

2020 ◽  
Vol 203 ◽  
pp. e817-e818
Author(s):  
Kerry Kilbridge ◽  
William Martin-Doyle* ◽  
Christopher Filson ◽  
Quoc-Dien Trinh ◽  
Sierra Williams ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Decision Making ◽  
African American ◽  
Health Literacy ◽  
Cancer Patients ◽  
Shared Decision Making ◽  
Shared Decision

scholarly journals Prognostic Genomic Tissue-Based Biomarkers in the Treatment of Localized Prostate Cancer

2022 ◽  
Vol 12 (1) ◽  
pp. 65
Author(s):  
Gianluca Ingrosso ◽  
Emanuele Alì ◽  
Simona Marani ◽  
Simonetta Saldi ◽  
Rita Bellavita ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Decision Making ◽  
Clinical Decision Making ◽  
Positive Impact ◽  
Wide Spectrum ◽  
Locally Advanced ◽  
Treatment Strategies ◽  
Quality Criteria ◽  
Localized Prostate Cancer ◽  
Decision Making Process

In localized prostate cancer clinicopathologic variables have been used to develop prognostic nomograms quantifying the probability of locally advanced disease, of pelvic lymph node and distant metastasis at diagnosis or the probability of recurrence after radical treatment of the primary tumor. These tools although essential in daily clinical practice for the management of such a heterogeneous disease, which can be cured with a wide spectrum of treatment strategies (i.e., active surveillance, RP and radiation therapy), do not allow the precise distinction of an indolent instead of an aggressive disease. In recent years, several prognostic biomarkers have been tested, combined with the currently available clinicopathologic prognostic tools, in order to improve the decision-making process. In the following article, we reviewed the literature of the last 10 years and gave an overview report on commercially available tissue-based biomarkers and more specifically on mRNA-based gene expression classifiers. To date, these genomic tests have been widely investigated, demonstrating rigorous quality criteria including reproducibility, linearity, analytical accuracy, precision, and a positive impact in the clinical decision-making process. Albeit data published in literature, the systematic use of these tests in prostate cancer is currently not recommended due to insufficient evidence.

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