Mobile Audio Recording Technology to Promote Informed Decision Making in Advanced Prostate Cancer

Abstract

PURPOSE Men with metastatic castration-resistant prostate cancer increasingly encounter complex treatment decisions. Consultation audio recordings and summaries promote patient informed decision making but are underutilized. Mobile recording software applications may increase access. Little is known regarding the feasibility of implementation in clinical encounters. METHODS We conducted a mixed-methods pilot study in men with progressive metastatic castration-resistant prostate cancer. We instructed patients to use a mobile software application to record an oncology visit. Patients could share the recording with our patient scribing program to receive a written summary. We assessed feasibility and acceptability with postvisit surveys. We measured patient-reported helpfulness of the intervention in decision making and change in Decisional Conflict Scale–informed subscale. We conducted semistructured interviews to explore implementation and analyzed transcripts using thematic analysis. RESULTS Across 20 patients, 18 (90%) recorded their visits. Thirteen of 18 (72%) listened to the recording, and 14 of 18 (78%) received a summary. Eighteen of 20 (90%) visits were telehealth. Fourteen patients (70% of all 20; 78% of 18 question respondents) found the application easy to use. Nine patients (50% of 18 recording patients; 90% of 10 question respondents) reported that the recording helped treatment decision making. Decisional conflict decreased from baseline to 1-week postvisit (47.4-28.5, P < .001). Interviews revealed benefits, facilitators, contextual factors, and technology and patient-related barriers to recordings and summaries. CONCLUSION In this single-institution academic setting, a mobile application for patients to record consultations was a feasible, acceptable, and potentially valued intervention that improved decision making in the telehealth setting. Studies in larger, diverse populations are needed.

A Decision Support Application for Patients with Cancer: A Feasibility Study

“…With regard to mobile technologies related to decision support for patients with cancer, the development of applications that contain information about the basic biology of breast cancer, different treatments used, and surgical techniques has achieved signi cant reductions in anxiety in patients who have less information compared to those who have more information [8]. Furthermore, mobile apps for patients to record their consultations improve decision-making in telemedicine settings [9], and the Cancer Health Aid to Manage Preferences and Improve Outcomes through Navigation (CHAMPION) may positively impact the well-being of patients and decision-making partners by reducing decision inconsistencies and regret associated with complex treatment-based decisions and cancer health disparities [10]. While the main functions of decision-making support are information provision, self-monitoring, and navigation, the main function of this study is to clarify patient values.…”