To determine whether or not decision aid (DA) use influences treatment decisions in patients with low and intermediate risk prostate cancer (PC).
In a cluster randomized controlled trial, patients were randomized to either DA use (DA group) or no DA use (control group). Between 2014 and 2016, newly diagnosed patients with low or intermediate risk PC were recruited in 18 hospitals in the Netherlands. DA users had access to a web-based DA that provided general PC information, PC-treatment information, and values clarification exercises to elicit personal preferences towards the treatment options. Control group patients received care as usual. Differences in treatment choice were analysed using multilevel logistic regressions. Differences in eligible treatment options between groups were compared using Pearson Chi-square tests.
Informed consent was given by 382 patients (DA group N = 273, control group N = 109). Questionnaire response rate was 88% (N = 336). Active surveillance (AS) was an option for 38%, radical prostatectomy (RP) for 98%, external beam radiotherapy (EBRT) for 88%, and brachytherapy (BT) for 79% of patients. DA users received AS significantly more often than control group. Patients (29 vs 16%, p = 0.01), whereas the latter more often chose BT (29 vs 18%, p < 0.01). No differences were found between groups regarding RP and EBRT. DA users who were not eligible for AS, received surgery more often compared to the control group (53 vs 35%, p = 0.01). Patient and disease characteristics were evenly distributed between groups.
DA-using PC patients chose the AS treatment option more often than non-DA-using patients did.
World journal of urology. 2021 Jul 17 [Epub ahead of print]
Romy E D Lamers, Maarten Cuypers, Marieke de Vries, Lonneke V van de Poll-Franse, J L H Ruud Bosch, Paul J M Kil
Department of Urology, University Medical Center, Utrecht, The Netherlands. ., Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525, Nijmegen, The Netherlands., Institute for Computing and Information Sciences (iCIS) and Social and Cultural Psychology, Behavioural Science Institute, Radboud University, Mercator I, Toernooiveld 216, 6525, Nijmegen, The Netherlands., Department of Research, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands., University Medical Cancer Center Utrecht, Heidelberglaan 100, 3584, Utrecht, The Netherlands., Andros Clinics, Mr. E.N. van Kleffensstraat 5, 6842 CV, Arnhem, The Netherlands.