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Randomized Controlled Trial
. 2012 Sep 28:10:123.
doi: 10.1186/1477-7525-10-123.

Personal preferences and discordant prostate cancer treatment choice in an intervention trial of men newly diagnosed with localized prostate cancer

Jaclyn L F Bosco  1 , Barbara Halpenny, Donna L Berry
Affiliations
Randomized Controlled Trial

Personal preferences and discordant prostate cancer treatment choice in an intervention trial of men newly diagnosed with localized prostate cancer

Jaclyn L F Bosco et al. Health Qual Life Outcomes. .

Abstract

Background: Men diagnosed with localized prostate cancer (LPC) can choose from multiple treatment regimens and are faced with a decision in which medical factors and personal preferences are important. The Personal Patient Profile-Prostate (P3P) is a computerized decision aid for men with LPC that focuses on personal preferences. We determined whether the P3P intervention improved the concordance of treatment choice with self-reported influential side-effects compared with a control group.

Methods: English/Spanish-speaking men diagnosed with LPC (2007-2009) from four US cities were enrolled into a randomized trial and followed through 6-months via mailed or online questionnaire. Men were randomized to receive the P3P intervention or standard education plus links to reputable websites. We classified choice as concordant if men were concerned with (a) sexual function and chose external beam radiotherapy or brachytherapy, (b) bowel function and chose prostatectomy, (c) sex, bowel, and/or bladder function and chose active surveillance, or (d) not concerned with any side effect and chose any treatment. Using logistic regression, we calculated odds ratios (OR) and 95% confidence intervals (CI) for the association between the P3P intervention and concordance.

Results: Of 448 men, most were <65 years, non-Hispanic white, had multiple physician consultations prior to enrollment, and chose a treatment discordant with concerns about potential side effects. There was no significant difference in concordance between the intervention (45%) and control (50%) group (OR = 0.82; 95%CI = 0.56, 1.2).

Conclusions: The P3P intervention did not improve concordance between potential side effects and treatment choice. Information and/or physician consultation immediately after diagnosis was likely to influence decisions despite concerns about side effects. The intervention may be more effective before the first treatment options consultation.

Trial registration: NCT00692653 http://clinicaltrials.gov/ct2/show/NCT00692653.

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References

    1. Mauger Rothenberg B, Marbella A, Belinson SE, Samson DJ, Bonnell CJ, Ziegler KM, Aronson N. Future Research Needs for Comparative Effectiveness of Treatments for Localized Prostate Cancer. Future Research Needs Paper No. 4. (Prepared by Blue Cross and Blue Shield Association, Technology Evaluation Center Evidence-based Practice Center under Contract No. 290-2007-10058-I.) Agency for Healthcare Research and Quality, Rockville, MD; 2010. Available at: www.effectivehealthcare.ahrq.gov/reports/final.cfm. - PubMed
    1. Holmboe ES, Concato J. Treatment decisions for localized prostate cancer: asking men what's important. J Gen Intern Med. 2000;15:694–701. doi: 10.1046/j.1525-1497.2000.90842.x. - DOI - PMC - PubMed
    1. Zeliadt SB, Ramsey SD, Penson DF, Hall IJ, Ekwueme DU, Stroud L, Lee JW. Why do men choose one treatment over another? Cancer. 2006;106(9):1865–1874. doi: 10.1002/cncr.21822. - DOI - PubMed
    1. Branney P, White A, Jain S, Hiley C, Flowers P. Choosing Health, Choosing Treatment: Patient Choice After Diagnosis of Localized Prostate Cancer. Urology. 2009;74(5):968–971. doi: 10.1016/j.urology.2009.03.015. - DOI - PubMed
    1. Sanda MG, Dunn RL, Michalski J, Sandler HM, Northouse L, Hembroff L, Lin X, Greenfield TK, Litwin MS, Saigal CS. et al.Quality of Life and Satisfaction with Outcome among Prostate-Cancer Survivors. N Engl J Med. 2008;358(12):1250–1261. doi: 10.1056/NEJMoa074311. - DOI - PubMed

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