Examining the effectiveness and implementation of patient treatment decision‐aid tools for men with localised prostate cancer: A systematic review

Todio, Elizabeth; Sharp, Jessica; Morrow, April; Taylor, Natalie; Schofield, Penelope; Mazariego, Carolyn

doi:10.1002/pon.6094

Cited by 5 publications

(13 citation statements)

References 74 publications

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“…DAs have been shown to improve knowledge, risk perception accuracy, congruence between values and choices, patient–clinician communication and decisional involvement and satisfaction and decrease decisional conflict and the uptake of unnecessary surgery across treatment and screening settings 14 . A recent systematic review of DAs designed specifically to support treatment decisions in PC concluded that, while DAs appear to increase knowledge, findings regarding decisional conflict, regret and satisfaction, decisional involvement and treatment choices vary from no impact to only modest effects, highlighting some shortcomings of existing DAs 15 …”

Section: Introductionmentioning

confidence: 99%

“…The aim of the present study was to develop an online treatment decision aid (OTDA) for Australian men with LRPC and their partners, titled Navigate . While several OTDAs for LRPC currently exist, these have most often been developed in the United States and the Netherlands 15 . Treatment decisions are inevitably made with reference to the patient's own personal and medical context, including the specific local healthcare system.…”

Section: Introductionmentioning

confidence: 99%

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Co‐designing an online treatment decision aid for men with low‐risk prostate cancer: Navigate

Schofield,

Hyatt,

White

et al. 2023

BJUI Compass

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ObjectivesTo develop an online treatment decision aid (OTDA) to assist patients with low‐risk prostate cancer (LRPC) and their partners in making treatment decisions.Patients and methodsNavigate, an OTDA for LRPC, was rigorously co‐designed by patients with a confirmed diagnosis or at risk of LRPC and their partners, clinicians, researchers and website designers/developers. A theoretical model guided the development process. A mixed methods approach was used incorporating (1) evidence for essential design elements for OTDAs; (2) evidence for treatment options for LRPC; (3) an iterative co‐design process involving stakeholder workshops and prototype review; and (4) expert rating using the International Patient Decision Aid Standards (IPDAS). Three co‐design workshops with potential users (n = 12) and research and web‐design team members (n = 10) were conducted. Results from each workshop informed OTDA modifications to the OTDA for testing in the subsequent workshop. Clinician (n = 6) and consumer (n = 9) feedback on usability and content on the penultimate version was collected.ResultsThe initial workshops identified key content and design features that were incorporated into the draft OTDA, re‐workshopped and incorporated into the penultimate OTDA. Expert feedback on usability and content was also incorporated into the final OTDA. The final OTDA was deemed comprehensive, clear and appropriate and met all IPDAS criteria.ConclusionNavigate is an interactive and acceptable OTDA for Australian men with LRPC designed by men for men using a co‐design methodology. The effectiveness of Navigate in assisting patient decision‐making is currently being assessed in a randomised controlled trial with patients with LRPC and their partners.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Co‐designing an online treatment decision aid for men with low‐risk prostate cancer: Navigate

Schofield,

Hyatt,

White

et al. 2023

BJUI Compass

Self Cite

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confidence: 99%

“…2 A recent review evaluated 21 different decision aids for men with localized prostate cancer, varying in presentation and format, with most being designed as computer/Web-based multimedia programs, a few as booklets, and some in video format. 3 Previous evaluation studies of finalized decision aids-a recent Cochrane review of 105 randomized trials would be an excellent example-have been mainly quantitative: researchers compare endpoints such as treatment choices, decisional conflict, or decisional regret. 4,5 The literature is far sparser for qualitative studies of postprocess evaluation of how patients feel about the tool.…”

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confidence: 99%

Patient Perceptions of a Decision Support Tool for Men with Localized Prostate Cancer

Austria

Kimberlin

et al. 2023

MDM Policy & Practice

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Purpose. To evaluate patient perceptions of a Web-based decision aid for the treatment of localized prostate cancer. Methods. We assessed patient perceptions of a multicomponent, Web-based decision aid with a preference elicitation/values clarification exercise using adaptive conjoint analysis, the generation of a summary report, and provision of information about localized prostate cancer treatment options. Using a think-aloud approach, we conducted 21 cognitive interviews with prostate cancer patients presented with the decision aid prior to seeing their urologist. Thematic content analysis was used to examine patient perceptions of the tool’s components and content prior to engaging in shared decision making with their clinician. Results. Five themes were identified: 1) patients had some negative emotional reactions to the tool, pointing out what they perceived to be unnecessarily negative framing and language used; 2) patients were forced to stop and think about preferences while going through the tool and found this deliberation to be useful; 3) patients were confused by the tool; 4) patients tried to discern the intent of the conjoint analysis questions; and 5) there was a disconnect between patients’ negative reactions while using the tool and a contrasting general satisfaction with the final “values profile” created by the tool. Conclusions. Studies are needed to explore the disconnect between patients’ expressing negative reactions while going through some components of decision aids but satisfaction with the final output. In particular, we hypothesize that this effect might be explained by cognitive biases such as choice-supportive bias, hindsight bias, and the “IKEA effect.” This is one of the first projects to elicit patient reactions while they were completing a decision aid, and we recommend further similar, qualitative postprocess evaluation studies. Highlights We explored perceptions of a decision aid with education about localized prostate cancer treatment and preference elicitation using adaptive conjoint analysis. Patients found the tool useful but were also confused by it, tried to discern the intent of the questions, and expressed negative emotional reactions. In particular, there was a disconnect between patients’ negative reactions while using the tool and general satisfaction with the final values profile generated by the tool, which is an area for future research.

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“…See a recent review examining the effectiveness and implementation of patient treatment DA tools for men with localized prostate cancer for further evaluation. 14 The Navigate DA Web site was created to assist Australian men with LPC make informed decisions about their treatment. 15 Navigate was co-designed by a multidisciplinary team and consumers, is theoretically driven, and complies with the International Patient Decision Aid Standards (IPDAS).…”

mentioning

confidence: 99%

A Qualitative Study of Men’s Experiences Using Navigate: A Localized Prostate Cancer Treatment Decision Aid

Todio,

Schofield,

Sharp

2023

MDM Policy & Practice

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Background. Men diagnosed with localized prostate cancer (LPC) often face a dilemma in choosing between available treatment options that have similar survival rates but for which the perceived advantages and disadvantages of each treatment differ. The Navigate decision aid was created to assist Australian men with LPC in making informed decisions about treatment that align with their personal values and preferences. Navigate presents current, unbiased information, including an interactive values clarification exercise. Objective. This study was a qualitative investigation of men’s treatment decision making for LPC, and their experiences using the Navigate Web site, to identify areas for improvement and inform implementation. Methods. Semi-structured interviews were conducted with 20 men diagnosed with LPC who completed the intervention arm of the Navigate randomized controlled trial. Interview transcripts were thematically analyzed. Results: Five main themes emerged: 1) diagnosis experiences varied, although men were strongly influenced by their clinician to make an early initial treatment decision; 2) men sought resources and support they trusted; 3) men valued Navigate’s multiformatted content and design; 4) men suggested more content was needed on a) the diagnosis journey and b) new treatment updates; and 5) men identified design flaws in the values clarification exercise on Navigate but appreciated the tool being available. Conclusions. Specialist authority influenced men to make an early treatment decision. However, Navigate was helpful in supporting men’s ongoing treatment decision making, particularly men on active surveillance who may face further treatment decisions if their cancer progresses. To gain trust and improve engagement from Navigate users, credentials and sources of information need to be prominent. Trustworthiness, timing of access, and the clinician’s role in empowering men to use available decision aids are crucial elements to be considered when implementing Navigate in clinical settings. Highlights The Navigate decision aid Web site was created to help Australian men diagnosed with localized prostate cancer (LPC) make an informed decision about their treatment. Navigate was helpful in supporting men’s ongoing treatment decision making for LPC. Men’s treatment decision making for LPC was greatly influenced by perceived authority and trust in their clinician. Trustworthiness, timing of access, and the clinician’s role in empowering men to use available decision aids are crucial.

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Examining the effectiveness and implementation of patient treatment decision‐aid tools for men with localised prostate cancer: A systematic review

Cited by 5 publications

References 74 publications

Co‐designing an online treatment decision aid for men with low‐risk prostate cancer: Navigate

Co‐designing an online treatment decision aid for men with low‐risk prostate cancer: Navigate

Patient Perceptions of a Decision Support Tool for Men with Localized Prostate Cancer

A Qualitative Study of Men’s Experiences Using Navigate: A Localized Prostate Cancer Treatment Decision Aid

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