title: Consultation audio-recording reduces long-term decision regret after prostate cancer treatment: A non-randomised comparative cohort study.
abstract: BACKGROUND
  The life expectancy of prostate patients is long and patients will spend many years carrying the burdens & benefits of the treatment decisions they have made, therefore, it is vital that decisions on treatments are shared between patient and physician. The objective was to determine if consultation audio-recording improves quality of life, reduces regret or improves patient satisfaction in comparison to standard counselling.
  
  
  METHODS
  In 2012 we initiated consultation audio-recordings, where patients are given a CD of their consultation to keep and replay at home. We conducted a prospective non-randomised study of patient satisfaction, quality of life (QOL) and decision regret at 12 months follow-up using posted validated questionnaires for the audio-recording (AR) patients and a control cohort. Qualitative and thematic analyses were used.
  
  
  RESULTS
  Forty of 59 patients in the AR group, and 27 of 45 patients in the control group returned the questionnaires. Patient demographics were similar in both groups with no statistically significant differences between the two groups. Decision regret was lower in the audio-recording group (11/100) vs control group (19/100) (p = 0.04). The risk ratio for not having any long-term decision regret was 5.539 (CI 1.643-18.674), with NNT to prevent regret being 4. Regression analysis showed that receiving audio-recording was strongest predictor for absence of regret even greater than potency and incontinence.
  
  
  CONCLUSIONS
  The study has shown that audio-recording clinic consultation reduces long-term decision regret, increases patient information recall, understanding and confidence in their decision. There is great potential for further expansion of this low-cost intervention.
authors: Department of Urology, Western General Hospital, NHS Lothian, Edinburgh, UK; Edinburgh Urological Cancer Group, University of Edinburgh, Edinburgh, UK. Electronic address: daniel.good@ed.ac.uk.
authors: Daniel W
authors: DW
authors: Good
authors: Department of Urology, Western General Hospital, NHS Lothian, Edinburgh, UK; Edinburgh Urological Cancer Group, University of Edinburgh, Edinburgh, UK.
authors: Harry
authors: H
authors: Delaney
authors: Department of Urology, Western General Hospital, NHS Lothian, Edinburgh, UK; Edinburgh Urological Cancer Group, University of Edinburgh, Edinburgh, UK.
authors: Alexander
authors: A
authors: Laird
authors: Clinical Psychology, Edinburgh Cancer Centre, Edinburgh, UK.
authors: Belinda
authors: B
authors: Hacking
authors: Department of Urology, Western General Hospital, NHS Lothian, Edinburgh, UK; Edinburgh Urological Cancer Group, University of Edinburgh, Edinburgh, UK.
authors: Grant D
authors: GD
authors: Stewart
authors: Department of Urology, Western General Hospital, NHS Lothian, Edinburgh, UK; Edinburgh Urological Cancer Group, University of Edinburgh, Edinburgh, UK.
authors: S Alan
authors: SA
authors: McNeill
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003657:Decision Making; D004644:Emotions; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000523:psychology* / Q000628:therapy*; D011788:Quality of Life; D012017:Referral and Consultation; D011795:Surveys and Questionnaires
keywords: Active surveillance; Audio-recording; Brachytherapy; Decision regret; Prostate cancer; Radical prostatectomy; Radiotherapy