Patient-physician-communication and health related quality of life of localized prostate cancer patients undergoing radical prostatectomy - a longitudinal multilevel analysis.

OBJECTIVES - To examine whether patient-physician-communication is associated with health related quality of life (HRQoL) in a sample of localized prostate cancer patients after radical prostatectomy.

PATIENTS AND METHODS - HAROW is a prospective, observational study designed to collect data of the different treatment options (Hormonal therapy, Active Surveillance, Radiation, Operation, Watchful Waiting) for newly diagnosed patients with localized prostate cancer under real life conditions.

At 6-months intervals, clinical data (D'Amico risk categories, Charlson comorbidity index) aspects of patient-provider-communication (standardized psychosocial care-instrument for patients' assessment of communication; Cologne Patient Questionnaire), and HRQoL (EORTC QLQ-C30) were assessed. Data were analyzed by longitudinal multilevel analysis.

RESULTS - Completed questionnaires for N=1.772 patients undergoing a prostatectomy were analyzed for a 3 year follow-up period. Patients rate the patient-provider communication generally high with slight variations over the course of treatment (3.2-3.8). The HRQoL of the patients shows substantial variation over time and between the reported subscales (Global Qol 71,1-77,2; physical functioning 89,1-92,1; role functioning 81,0-88,1; emotional functioning 74,4-84,0; cognitive functioning 84,3-87,7; social functioning 77,7-84,0). The longitudinal multilevel models showed significant associations between the patient-provider communication in terms of devotion, support and co-therapy and functional aspects of HRQoL.

CONCLUSIONS - Patient-provider communication is a valuable resource to support prostate cancer patients' coping with the disease and to improve their HRQoL. Future interventions should be designed especially for urologists to enhance their awareness for the importance of communication and the relationship to their prostate cancer patients for treatment outcomes. This article is protected by copyright. All rights reserved.

BJU international. 2016 Apr 01 [Epub ahead of print]

N Ernstmann, L Weissbach, J Herden, N Winter, L Ansmann

Institute for Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), University of Cologne, Eupener Str. 129, 50933, Cologne, Germany., Stiftung Maennergesundheit, Claire-Waldoff-Straße 3, 10117, Berlin, Germany., University Hospital of Cologne, Department of Urology, Kerpener Strasse 62, 50937, Cologne, Germany., University Hospital of Cologne, Department of Urology, Kerpener Strasse 62, 50937, Cologne, Germany., Institute for Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), University of Cologne, Eupener Str. 129, 50933, Cologne, Germany.