MP25-04 IMPACT OF A NOVEL METHOD OF PATIENT PREFERENCE ELICITATION ON DECISION QUALITY IN MEN WITH PROSTATE CANCER

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Quality of Life and Shared Decision Making I1 Apr 2016MP25-04 IMPACT OF A NOVEL METHOD OF PATIENT PREFERENCE ELICITATION ON DECISION QUALITY IN MEN WITH PROSTATE CANCER Joseph Shirk, Alan Kaplan, Josemanuel Saucedo, Sylvia Lambrechts, Ely Dahan, Kate Crespi, and Christopher Saigal Joseph ShirkJoseph Shirk More articles by this author , Alan KaplanAlan Kaplan More articles by this author , Josemanuel SaucedoJosemanuel Saucedo More articles by this author , Sylvia LambrechtsSylvia Lambrechts More articles by this author , Ely DahanEly Dahan More articles by this author , Kate CrespiKate Crespi More articles by this author , and Christopher SaigalChristopher Saigal More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.781AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Shared decision making can assist men with localized prostate cancer in making informed decisions. The added benefit of patient preference measurement in this setting is not known. We investigated satisfaction and decisional quality in patients who had exposure to a standard decision aid, with and without preference clarification. METHODS We developed a software-based preference assessment method which used conjoint analysis to allow preference measurement. 122 men with incident localized prostate cancer were recruited in the West LA Veterans Affairs Urology Clinic and randomized to a control group that received education with a brochure about prostate cancer treatment only or a treatment group that received preference assessment prior to the clinic visit in addition to the brochure and received a report detailing the strength of their preferences for treatment attributes. The men were then surveyed with instruments measuring elements of decision quality and patient satisfaction with care. RESULTS Baseline knowledge scores were low (average 62%). The average ± SD total score on the Decisional Conflict Scale (DCS) was 2.3 ± 0.9, signifying a moderate level of baseline decisional conflict. There was a significant difference in the pre- to post-consultation change in DCS score between the control and treatment groups in the Perceived Effective Decision Making subscale (p=.003) as well as the total score (p=.023)(Figure). When comparing all interventions to active surveillance and patients unsure about treatment, there was a significant change in patient preference towards surgery in the treatment group when compared to control group (35% pre-consultation to 47% post-consultation in education only group vs 44% pre-consultation to 63% post-consultation in education with conjoint analysis group (p=.043). CONCLUSIONS Individual-level, conjoint analysis-based preference assessment is feasible in the clinic setting. We show that prostate cancer patients who undergo values clarification with conjoint analysis are more certain about their treatment decisions and have decreased levels of conflict when making these decisions. Preference assessment provided benefit above and beyond that achieved with educational content alone in men facing a treatment decision for prostate cancer. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e279-e280 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Joseph Shirk More articles by this author Alan Kaplan More articles by this author Josemanuel Saucedo More articles by this author Sylvia Lambrechts More articles by this author Ely Dahan More articles by this author Kate Crespi More articles by this author Christopher Saigal More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...