Using a web-based decision support intervention to facilitate patient-physician communication at prostate cancer treatment discussions

B. Joyce Davison, Michael Szafron, Carl Gutwin, Kishore Visvanathan

Abstract


Purpose: To measure the preferences and values of men newly diagnosed with prostate cancer (PC) using a web-based decision support technology—the Decision Support Intervention-Prostate Cancer (DSI-PC).

Methods: Health information seeking behaviour, factors having an influence on the treatment decision, decision control, and preferred treatment were recorded by the DSI-PC program prior to the treatment consultation. A summary page of responses was provided to each patient to use at treatment discussions. Measures of decision control and decision conflict were measured prior to the treatment discussion, and following a treatment decision. Patient satisfaction was measured after a treatment decision had been made.

Results: Forty-nine men completed the DSI-PC program prior to their treatment discussion. Sixty-one per cent shared the summary sheet with their physician/s when discussing treatment options. The majority (63%) of patients wanted access to in-depth or detailed information. Impact of treatment on survival, urinary function, bowel function, and physician’s treatment recommendation were the four factors having the most influence on patients’ treatment decisions. Patients reported high levels of satisfaction with their treatment decision, and involvement in treatment decision making (TDM). Levels of decision conflict were significantly lower (p < 0.001) after a treatment decision was made, and men reported assuming a significantly more active role in TDM than originally preferred (p = 0.038).

Conclusions: Results suggest that the DSI-PC intervention may be a useful tool to help patients identify and communicate their values and preferences to physicians at the time of treatment discussions.

Key words: prostate cancer, patient-physician communication, decision support intervention


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References


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