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.
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.