Abstract
Purpose
To compare patients' evaluation of the treatment decision-making process in localized prostate cancer between counseling that included an online decision aid (DA) and standard counseling.
Methods
Eighteen Dutch hospitals were randomized to DA counseling (n = 235) or the control group with standard counseling (n = 101) in a pragmatic, cluster randomized controlled trial. The DA was provided to patients at, or soon after diagnosis. Decisional conflict, involvement, knowledge, and satisfaction with information were assessed with a questionnaire after treatment decision-making. Anxiety and depression served as covariates.
Results
The levels of decision involvement and conflict were comparable between patients in both groups. Patients with a DA felt more knowledgeable but scored equally well on a knowledge test as patients without a DA. Small significant negative effects were found on satisfaction with information and preparation for decision-making. A preference for print over online and depression and anxiety symptoms was negatively associated with satisfaction and conflict scores in the DA group.
Discussion
The DA aimed to support shared decision-making, while outcomes for a majority of DA users were comparable to patients who received standard counseling. Patients, who are less comfortable with the online DA format or experience anxiety or depression symptoms, could require more guidance toward shared decision-making. To evaluate long-term DA effects, follow-up evaluation on treatment satisfaction and decisional regret will be done.
| Original language | English |
|---|---|
| Pages (from-to) | 3739-3748 |
| Journal | Supportive Care in Cancer |
| Volume | 26 |
| Issue number | 11 |
| DOIs | |
| Publication status | Published - 2018 |
Keywords
- Shared decision-making
- Decision aids
- Prostate cancer
- Oncology
- Information provision
- Patient-reported outcomes
- QUALITY-OF-LIFE
- ACTIVE SURVEILLANCE
- INFORMATION PROVISION
- CONFLICT SCALE
- INTERNET USE
- SATISFACTION
- ANXIETY
- VALIDATION
- DEPRESSION
- DIAGNOSIS
Cite this
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Impact of a web-based prostate cancer treatment decision aid on patient-reported decision process parameters : results from the Prostate Cancer Patient Centered Care trial. / Cuypers, Maarten; Lamers, Romy E. D.; Kil, Paul J. M.; van de Poll-Franse, Lonneke V.; de Vries, Marieke.
In: Supportive Care in Cancer, Vol. 26, No. 11, 2018, p. 3739-3748.Research output: Contribution to journal › Article › Scientific › peer-review
TY - JOUR
T1 - Impact of a web-based prostate cancer treatment decision aid on patient-reported decision process parameters
T2 - results from the Prostate Cancer Patient Centered Care trial
AU - Cuypers, Maarten
AU - Lamers, Romy E. D.
AU - Kil, Paul J. M.
AU - van de Poll-Franse, Lonneke V.
AU - de Vries, Marieke
PY - 2018
Y1 - 2018
N2 - Purpose To compare patients' evaluation of the treatment decision-making process in localized prostate cancer between counseling that included an online decision aid (DA) and standard counseling.Methods Eighteen Dutch hospitals were randomized to DA counseling (n = 235) or the control group with standard counseling (n = 101) in a pragmatic, cluster randomized controlled trial. The DA was provided to patients at, or soon after diagnosis. Decisional conflict, involvement, knowledge, and satisfaction with information were assessed with a questionnaire after treatment decision-making. Anxiety and depression served as covariates.Results The levels of decision involvement and conflict were comparable between patients in both groups. Patients with a DA felt more knowledgeable but scored equally well on a knowledge test as patients without a DA. Small significant negative effects were found on satisfaction with information and preparation for decision-making. A preference for print over online and depression and anxiety symptoms was negatively associated with satisfaction and conflict scores in the DA group.Discussion The DA aimed to support shared decision-making, while outcomes for a majority of DA users were comparable to patients who received standard counseling. Patients, who are less comfortable with the online DA format or experience anxiety or depression symptoms, could require more guidance toward shared decision-making. To evaluate long-term DA effects, follow-up evaluation on treatment satisfaction and decisional regret will be done.
AB - Purpose To compare patients' evaluation of the treatment decision-making process in localized prostate cancer between counseling that included an online decision aid (DA) and standard counseling.Methods Eighteen Dutch hospitals were randomized to DA counseling (n = 235) or the control group with standard counseling (n = 101) in a pragmatic, cluster randomized controlled trial. The DA was provided to patients at, or soon after diagnosis. Decisional conflict, involvement, knowledge, and satisfaction with information were assessed with a questionnaire after treatment decision-making. Anxiety and depression served as covariates.Results The levels of decision involvement and conflict were comparable between patients in both groups. Patients with a DA felt more knowledgeable but scored equally well on a knowledge test as patients without a DA. Small significant negative effects were found on satisfaction with information and preparation for decision-making. A preference for print over online and depression and anxiety symptoms was negatively associated with satisfaction and conflict scores in the DA group.Discussion The DA aimed to support shared decision-making, while outcomes for a majority of DA users were comparable to patients who received standard counseling. Patients, who are less comfortable with the online DA format or experience anxiety or depression symptoms, could require more guidance toward shared decision-making. To evaluate long-term DA effects, follow-up evaluation on treatment satisfaction and decisional regret will be done.
KW - Shared decision-making
KW - Decision aids
KW - Prostate cancer
KW - Oncology
KW - Information provision
KW - Patient-reported outcomes
KW - QUALITY-OF-LIFE
KW - ACTIVE SURVEILLANCE
KW - INFORMATION PROVISION
KW - CONFLICT SCALE
KW - INTERNET USE
KW - SATISFACTION
KW - ANXIETY
KW - VALIDATION
KW - DEPRESSION
KW - DIAGNOSIS
U2 - 10.1007/s00520-018-4236-8
DO - 10.1007/s00520-018-4236-8
M3 - Article
VL - 26
SP - 3739
EP - 3748
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
SN - 0941-4355
IS - 11
ER -