Mp48-18 patient satisfaction with the physician relationship impacts the effectiveness of decision aids in men with prostate cancer

You have accessJournal of UrologyCME1 Apr 2023MP48-18 PATIENT SATISFACTION WITH THE PHYSICIAN RELATIONSHIP IMPACTS THE EFFECTIVENESS OF DECISION AIDS IN MEN WITH PROSTATE CANCER Patrick Wilson, Jonathon Bergman, Jefersson Villatoro, Lorna Kwan, Kristen Williams, David Penson, and Christopher Saigal Patrick WilsonPatrick Wilson More articles by this author , Jonathon BergmanJonathon Bergman More articles by this author , Jefersson VillatoroJefersson Villatoro More articles by this author , Lorna KwanLorna Kwan More articles by this author , Kristen WilliamsKristen Williams More articles by this author , David PensonDavid Penson More articles by this author , and Christopher SaigalChristopher Saigal More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003294.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: We scaled a Decision Aid (DA) for men with prostate cancer in different healthcare settings to learn best practices for implementation across a variety of patient populations. This DA was previously shown to improve decision quality at an academic medical center (AMC). We aimed to understand whether patients who showed persistent decisional conflict exhibited distinct characteristics. METHODS: The DA (“WiserCare”) was issued to men with newly diagnosed prostate cancer at a public hospital and two AMCs prior to a clinic visit. The DA displays personalized clinical outcomes and measures preferences for these outcomes with conjoint analysis. We used the Decisional Conflict Scale (DCS) score to categorize patients as having no difficulty (<25), some difficulty (25-37.5), or severe difficulty (>37.5) with making a decision after using the DA, based on prior data. We measured DCS score, Net Promoter Score (likelihood to recommend the physician), and treatment choice after the visit. We evaluated differences in DCS scores using Chi-squared analysis. A Spanish language version DA was available. RESULTS: 1,961 men were invited to use the DA across three sites, and 1,098 did so. 356 completed the post-visit survey. Overall, DCS scores were excellent (total median 6.3 across sites). However, patients reporting “severe difficulty” had significantly worse Net Promoter Scores for their doctor compared to patients with “no difficulty.” Patients with “severe difficulty” were also more likely to be unsure of their treatment choice. Patient age, language, and disease risk did not have a significant association with difficulty with decision making. CONCLUSIONS: Prostate cancer SDM programs can be scaled successfully in public hospitals serving men of varying languages and SES, with overall preservation of DA effectiveness. Patients with persistent “severe difficulty” making decisions were less satisfied with their physician interactions. They were also more likely to remain undecided regarding treatment choice. Additional qualitative work with this population is needed to understand how the physician-patient relationship impacts SDM and whether DAs can be modified to further support specific patient needs. Source of Funding: Patient Centered Outcomes Research Institute (PCORI) © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e662 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Patrick Wilson More articles by this author Jonathon Bergman More articles by this author Jefersson Villatoro More articles by this author Lorna Kwan More articles by this author Kristen Williams More articles by this author David Penson More articles by this author Christopher Saigal More articles by this author Expand All Advertisement PDF downloadLoading ...