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

Health and Quality of Life Outcomes

Research

Jaclyn LF Bosco¹  Barbara Halpenny¹  Donna L Berry¹ 

[1] Dana-Farber Cancer Institute, LW 519, 450 Brookline Avenue, 02215, Boston, MA, USA;

关键词: Localized prostate cancer;    Randomized trial;    Decision making;    Treatment;    Patient preferences;    Quality of life;   

DOI  :  10.1186/1477-7525-10-123

 received in 2012-02-21, accepted in 2012-09-18,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundMen 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.MethodsEnglish/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.ResultsOf 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).ConclusionsThe 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 registrationNCT00692653 http://clinicaltrials.gov/ct2/show/NCT00692653

【 授权许可】

CC BY   
© Bosco et al.; licensee BioMed Central Ltd. 2012