Provider and partner interactions in the treatment decision-making process for newly diagnosed localized prostate cancer - Abstract

Department of Veterans Affairs Medical Center, University of Washington, Fred Hutchinson Cancer Research Center, Seattle, WA. Vanderbilt University Medical Center, Nashville, TN; Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA; University of Texas Health Science Center at San Antonio, TX; Medical University of South Carolina, Charleston, SC, USA.

Study Type - Patient experience (non-consecutive cohort) Level of Evidence 3b.

To evaluate the degree to which the partners of prostate cancer patients participate in the shared decision-making process with the patients' providers during the time between diagnosis and initiating treatment.

We recruited patients with newly diagnosed local-stage prostate cancer and their partners to complete take-home surveys after biopsy but before initiating treatment at urology practices in three states. We asked partners to describe their roles in the decision-making process, including participation in clinic visits, and perceptions of encouragement from providers to participate in the treatment decision-making process. We also asked partners to rate their satisfaction with the patients' providers.

Family members of 80% of newly diagnosed patients agreed to participate; most (93%) were partners (i.e. spouses or significant others). Most partners (93%) had direct contact with the patients' physicians. Among the partners who had contact with providers, most (67%) were very satisfied with the patients' providers and 80% indicated that the doctor encouraged them to participate in the treatment decision. Overall, 91% of partners reported very frequent discussions with their loved one about the pending treatment decision, and 69% reported that their role was to help the patient make a decision. In multivariate models, provider encouragement of partner participation was associated with higher partner satisfaction (odds ratio 3.4, 95% CI 1.4-8.4) and an increased likelihood of partners reporting very frequent discussions with their loved one (odds ratio 6.1, 95% CI 1.3-27.7).

Partners often attended clinic visits and were very involved in discussions about treatment options with both loved ones and providers. Provider encouragement of participation by partners greatly facilitates shared decision-making between patients and partners.

Written by:
Zeliadt SB, Penson DF, Moinpour CM, Blough DK, Fedorenko CR, Hall IJ, Smith JL, Ekwueme DU, Thompson IM, Keane TE, Ramsey SD.   Are you the author?

Reference: BJU Int. 2011 Jan 18. Epub ahead of print.
doi: 10.1111/j.1464-410X.2010.09945.x

PubMed Abstract
PMID: 21244609

UroToday.com Prostate Cancer Section