Some Prostate Cancer Patient Decision Aids Need Updating

MedicalResearch.com Interview with:
Prajakta Adsul, MBBS, MPH, PhD; Ricardo Wray, PhD, and Sameer Siddiqui, MD
Center for Cancer Prevention, Research and Outreach
Saint Louis University

MedicalResearch: What is the background for this study? What are the main findings?

Response: Patient decision aids are interventions designed to help patients engage in shared decision making with their providers when multiple choices with more or less equivalent efficacy are available for a particular medical decision. Several patient decision aids exists for numerous medical conditions and previous research has demonstrated them to be effective in improving the patient’s knowledge and understanding of treatment options and their relative efficacy and side-effects and resulting in a higher proportion of decision that are consistent with patient’s values and personal preferences.

In the context of prostate cancer treatment, the practice of shared decision making is vital as highlighted by recent calls from the American Urological Association and the American Cancer Society. To aid with this process, several patient decision aids exist. However, the content presented, the format and presentation styles of decision aids can be variable and can have an influence on the choice made by the patients. The purpose of this study was to assess the characteristics of the patient decision aids designed for men facing prostate cancer treatment. We used the widely accepted International Patient Decision Aids Standards (IPDAS) for the assessment, supplemented with implementation criteria to strategize successful future improvement and promotion of decision aids in routine urological practice.

The main findings of the review were that none of the decision aids reviewed met all standards. The aids had variable content, format and presentation of prostate cancer treatment information. Several decision aids were outdated and critical issues such as the risk of overtreatment and active surveillance as a treatment option for prostate cancer were not always covered in decision aids.

MedicalResearch: What should clinicians and patients take away from your report?

Response: Clinicians, especially urologists, should continue using and recommending their patients to use decision aids when engaging in shared decision making for treatment of prostate cancer. When doing so, they need to choose decision aids with characteristics that are best suited to their patient populations and their personal practice styles. The review highlights these characteristics of currently available decision aids.

For newly diagnosed prostate cancer patients, it is important to engage in shared decision making using decision aids and this review can help point out currently available decision aids and their characteristics.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Response: Decision aid developers need to address the IPDAS criteria more stringently and update decision aids to reflect the current medical evidence or lack thereof. Pre-testing decision aids and feasibility of use with both patients and the clinicians can also improve decision aid efficacy and further our understanding of how to promote widespread adoption of these aids in routine practice.

Citation:

Systematic Review of Decision Aids for Newly Diagnosed Prostate Cancer Patients Making Treatment Decisions

Prajakta Adsul, MBBS, MPH, PhD Ricardo Wray, PhD Kyle Spradling, BA Oussama Darwish, MD,Nancy Weaver, PhD, MS,Sameer Siddiqui, MD

Accepted: May 28, 2015; Published Online: June 05, 2015

Journal of Urology Publication stage: In Press Accepted Manuscript

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Prajakta Adsul, MBBS, MPH, PhD; Ricardo Wray, PhD, and Sameer Siddiqui, MD, Center for Cancer Prevention, Research and Outreach,  Saint Louis University (2015). Some Prostate Cancer Patient Decision Aids Need Updating