MP37-04 PILOT EVALUATION OF A PATIENT-CENTERED PROSTATE BIOPSY PATHOLOGY REPORT

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Quality of Life and Shared Decision Making IV1 Apr 2016MP37-04 PILOT EVALUATION OF A PATIENT-CENTERED PROSTATE BIOPSY PATHOLOGY REPORT Jasmir Nayak, Geolani Dy, Liam Macleod, Alice Chu, William Ellis, Daniel Lin, Lawrence True, Funda Vakar-Lopez, and John Gore Jasmir NayakJasmir Nayak More articles by this author , Geolani DyGeolani Dy More articles by this author , Liam MacleodLiam Macleod More articles by this author , Alice ChuAlice Chu More articles by this author , William EllisWilliam Ellis More articles by this author , Daniel LinDaniel Lin More articles by this author , Lawrence TrueLawrence True More articles by this author , Funda Vakar-LopezFunda Vakar-Lopez More articles by this author , and John GoreJohn Gore More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1681AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In prostate cancer (PCa) care, the biopsy pathology report elucidates grade and volume of disease, which are important for treatment decision-making. Yet, patients struggle interpreting this important document. Traditionally, patients have not been the primary audience for pathology reports resulting in reports with an excessively high reading level burden. We sought to design and evaluate a modified prostate biopsy report using patient centered outcomes research methods. METHODS We used a modified Delphi approach to achieve consensus from a multidisciplinary group of PCa experts for critical components of a prostate biopsy report for treatment decision-making. Patient focus groups reviewed these results and provided input on syntax and formatting to draft a candidate patient-centered pathology report (PCPR) for pilot evaluation. We prospectively recruited recently diagnosed PCa patients from May-October 2015, and randomized patients to receive either the PCPR + standard report (SR) or the SR alone. Web-based surveys assessed patient engagement with validated tools including: PAM (Patient Activation Measure), patient-physician relational empathy with CARE (Consultation And Relational Empathy), perceived health self-efficacy with PEPPI (Perceived Efficacy in Patient-Physician Interactions), perception on the utility of pathology reports in decision making with the Preparation for Decision Making Scale and a knowledge assessment based on elements of the report prioritized by our expert panel. We compared study groups with descriptive statistics. RESULTS A 24-member panel of prostate cancer experts prioritized primary and secondary Gleason score and number of positive cores. Patients preferred a narrative format, non-threatening language, and information on risk classification. Of 57 included patients, 88% were biopsied elsewhere and were seeking a second opinion for their PCa. Responses were received from 90% (27/30) in the PCPR and 93% (25/27) in the SR group. PCPR Patients trended towards improved recall of their Gleason score (89% vs. 80% SR, p=0.38) and the number of positive cores (74% vs. 56% SR, p=0.17). Patient activation, patient-physician communication and perceived self-efficacy scores were uniformly high. CONCLUSIONS PCPR were associated with a trend toward higher patient knowledge scores, a pillar of treatment-decision making in PCa care. The predominance of second opinion patients may have diluted the potential benefits of PCPR exposure. Further investigation into the effectiveness of PCPR for newly diagnosed prostate cancer patients is warranted. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e498 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Jasmir Nayak More articles by this author Geolani Dy More articles by this author Liam Macleod More articles by this author Alice Chu More articles by this author William Ellis More articles by this author Daniel Lin More articles by this author Lawrence True More articles by this author Funda Vakar-Lopez More articles by this author John Gore More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...