title: A longitudinal study of changes in provider-patient interaction in treatment of localized prostate cancer.
abstract: OBJECTIVE
  Whilst much is known as to the met and unmet communication needs of prostate cancer patients, few studies have been conducted on the changes in communication between provider and patient over time. Therefore, the aim of our study is to examine (a) whether there are changes over time in the quality of psychosocial care in long-term treatment of localized prostate cancer and (b) whether those changes are associated with the treatment decision.
  
  
  METHODS
  HAROW is a prospective, observational study designed to collect clinical data and patient reported outcomes (PROs) of different treatment options (hormonal therapy, active surveillance, radiation, operation, watchful waiting) for newly diagnosed patients with localized prostate cancer under real conditions. At 6-month intervals, general clinical data, PROs (e.g. quality of life, quality of physician-patient interaction) and individual costs are documented. We analysed data of N = 1,216 patients at the time of initial diagnosis (T1) and after 6 months (T2).
  
  
  RESULTS
  There is a significant decline in shared decision-making behaviour of physicians for the group of patients undergoing a prostatectomy and for the hormonal therapy group at the time of initial diagnosis and after 6 months. In terms of emotional support by physicians, there is a significant difference between the treatment groups at the time of initial diagnosis with patients undergoing a prostatectomy reporting significantly less support than the hormonal therapy group.
  
  
  CONCLUSIONS
  Future research from both, the providers' and the patients' perspective, will have to clarify if we can interpret our results as change in the communication behaviour once the treatment decision for prostatectomy or hormonal therapy is made.
authors.affiliation: Institute for Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Human Sciences and Faculty of Medicine, University of Cologne, Eupener Str. 129, 50933 Cologne, Germany. nicole.ernstmann@uk-koeln.de
authors.forename: Nicole
authors.initials: N
authors.lastname: Ernstmann
authors.forename: Oliver
authors.initials: O
authors.lastname: Ommen
authors.forename: Christoph
authors.initials: C
authors.lastname: Kowalski
authors.forename: Melanie
authors.initials: M
authors.lastname: Neumann
authors.forename: Adriaan
authors.initials: A
authors.lastname: Visser
authors.forename: Holger
authors.initials: H
authors.lastname: Pfaff
authors.forename: Lothar
authors.initials: L
authors.lastname: Weissbach
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D003142:Communication; D003657:Decision Making; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians' / Q000592:standards*; D011446:Prospective Studies; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000523:psychology / Q000628:therapy*; D011787:Quality of Health Care; D011788:Quality of Life; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D018931:Antineoplastic Agents, Hormonal