Decision Support and Shared Decision Making About Active Surveillance Versus Active Treatment Among Men Diagnosed with Low-Risk Prostate Cancer: a Pilot Study.

This study aimed to explore the effects of a decision support intervention (DSI) and shared decision making (SDM) on knowledge, perceptions about treatment, and treatment choice among men diagnosed with localized low-risk prostate cancer (PCa). At a multidisciplinary clinic visit, 30 consenting men with localized low-risk PCa completed a baseline survey, had a nurse-mediated online DS session to clarify preference for active surveillance (AS) or active treatment (AT), and met with clinicians for SDM. Participants also completed a follow-up survey at 30 days. We assessed change in treatment knowledge, decisional conflict, and perceptions and identified predictors of AS. At follow-up, participants exhibited increased knowledge (p < 0.001), decreased decisional conflict (p < 0.001), and more favorable perceptions of AS (p = 0.001). Furthermore, 25 of the 30 participants (83 %) initiated AS. Increased family and clinician support predicted this choice (p < 0.001). DSI/SDM prepared patients to make an informed decision. Perceived support of the decision facilitated patient choice of AS.

Journal of cancer education : the official journal of the American Association for Cancer Education. 2016 Jul 15 [Epub ahead of print]

Ronald E Myers, Amy E Leader, Jean Hoffman Censits, Edouard J Trabulsi, Scott W Keith, Anett M Petrich, Anna M Quinn, Robert B Den, Mark D Hurwitz, Costas D Lallas, Sarah E Hegarty, Adam P Dicker, Charnita M Zeigler-Johnson, Veda N Giri, Hasan Ayaz, Leonard G Gomella

Division of Population Science, Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA., Division of Population Science, Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA. ., Division of Population Science, Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA., Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA., Department of Pharmacology and Experimental Therapeutics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA., Division of Population Science, Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA., Division of Population Science, Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA., Department of Radiation Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA., Department of Radiation Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA., Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA., Department of Pharmacology and Experimental Therapeutics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA., Department of Radiation Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA., Division of Population Science, Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA., Division of Population Science, Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA., School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, USA., Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA.