title: Decision Support and Shared Decision Making About Active Surveillance Versus Active Treatment Among Men Diagnosed with Low-Risk Prostate Cancer: a Pilot Study.
abstract: 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.
authors.affiliation: Division of Population Science, Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA.
authors.forename: Ronald E
authors.initials: RE
authors.lastname: Myers
authors.affiliation: Division of Population Science, Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA. amy.leader@jefferson.edu.
authors.forename: Amy E
authors.initials: AE
authors.lastname: Leader
authors.affiliation: Division of Population Science, Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA.
authors.forename: Jean Hoffman
authors.initials: JH
authors.lastname: Censits
authors.affiliation: Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA.
authors.forename: Edouard J
authors.initials: EJ
authors.lastname: Trabulsi
authors.affiliation: Department of Pharmacology and Experimental Therapeutics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA.
authors.forename: Scott W
authors.initials: SW
authors.lastname: Keith
authors.affiliation: Division of Population Science, Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA.
authors.forename: Anett M
authors.initials: AM
authors.lastname: Petrich
authors.affiliation: Division of Population Science, Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Quinn
authors.affiliation: Department of Radiation Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA.
authors.forename: Robert B
authors.initials: RB
authors.lastname: Den
authors.affiliation: Department of Radiation Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA.
authors.forename: Mark D
authors.initials: MD
authors.lastname: Hurwitz
authors.affiliation: Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA.
authors.forename: Costas D
authors.initials: CD
authors.lastname: Lallas
authors.affiliation: Department of Pharmacology and Experimental Therapeutics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Hegarty
authors.affiliation: Department of Radiation Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA.
authors.forename: Adam P
authors.initials: AP
authors.lastname: Dicker
authors.affiliation: Division of Population Science, Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA.
authors.forename: Charnita M
authors.initials: CM
authors.lastname: Zeigler-Johnson
authors.affiliation: Division of Population Science, Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA.
authors.forename: Veda N
authors.initials: VN
authors.lastname: Giri
authors.affiliation: School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, USA.
authors.forename: Hasan
authors.initials: H
authors.lastname: Ayaz
authors.affiliation: Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA.
authors.forename: Leonard G
authors.initials: LG
authors.lastname: Gomella
mesh_terms: D002755:Choice Behavior; D003657:Decision Making; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D010865:Pilot Projects; D011159:Population Surveillance; D010818:Practice Patterns, Physicians'; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D057832:Watchful Waiting / Q000379:methods*
keywords: Active surveillance; Decision support interventions; Prostate cancer; Shared decision making