Physicians’ perspectives on the informational needs of low-risk prostate cancer patients

Abstract

Despite the evidence indicating that decision aids (DA) improve informed treatment decision making for prostate cancer (PCa), physicians do not routinely recommend DAs to their patients. We conducted semi-structured interviews with urologists (n = 11), radiation oncologists (n = 12) and primary care physicians (n = 10) about their methods of educating low-risk PCa patients regarding the treatment decision, their concerns about recommending DAs, and the essential content and format considerations that need to be addressed. Physicians stressed the need for providing comprehensive patient education before the treatment decision is made and expressed concern about the current unevaluated information available on the Internet. They made recommendations for a DA that is brief, applicable to diverse populations, and that fully discloses all treatment options (including active surveillance) and their potential side effects. Echoing previous studies showing that low-risk PCa patients are making rapid and potentially uninformed treatment decisions, these results highlight the importance of providing patient education early in the decision-making process. This need may be fulfilled by a treatment DA, should physicians systematically recommend DAs to their patients. Physicians' recommendations for the inclusion of particular content and presentation methods will be important for designing a high quality DA that will be used in clinical practice.

Describing perspectives of health care professionals on active surveillance for the management of prostate cancer

“…Most participants reported a variation in considering all these factors. However, none of them applied systematic decision-making approaches (i.e., decision boards) to assist patients in deciding a course of AS despite the fact that these tools gained favorable attention to communicate patient preferences, improve patient’s understanding of their disease, and reduce decisional regret [ 12 , 17 ].…”

Factors Affecting Engagement in Web-Based Health Care Patient Information: Narrative Review of the Literature

“…At different stages of a patient journey, decision aids may be used as adjunctive decision-making tools to support patients. In the study by Hagerman et al [ 50 ], the authors conducted semistructured interviews of 33 physicians to identify the desirable characteristics of decision aids. Of the 33 physicians, 20 (61%) stated that patients should be educated on the lack of urgency with regard to making a treatment decision.…”

Patient Factors That Influence How Physicians Discuss Active Surveillance With Low-Risk Prostate Cancer Patients: A Qualitative Study

“…Clinicians recognize the role family members play in influencing patients’ decisions about AS, and this research confirms the need to explore the best ways to achieve guideline-concordant care for patients amidst various relational and emotional pressures ( Showalter et al, 2015 ). Research is needed to better understand how third parties alter the decision process and urologists may need different tools to counsel patients and their family members to determine the preferred treatment option ( Hagerman et al, 2017 ). In particular, they may need training on how to manage the emotional responses that typically arise from both patients and their families when a diagnosis of prostate cancer is made ( Adsul et al, 2016 ).…”