Year: 2016
Type: article
Abstract: Patients were mailed follow-up questionnaires.Outcomes included perception of quality of care, knowledge of prostate cancer screening, and the decision to pursue screening.Statistical analyses included ANOVA models for continuous outcomes and logistic regression models for binary outcomes.RESULTS: A total of 329 patients were enrolled.Patients in the DA arm were significantly less likely to report that their provider encouraged them to talk about their health questions compared to those in the SOC arm (72%, 71/97, vs. 87%, 78/88, respectively, p¼0.014).However, the addition of SDM to DA did not significantly impact their perception of this interaction (78%, 70/88, vs. 87%, 78/88, respectively, p¼0.400).Interestingly, DA alone did not improve prostate knowledge compared to SOC (4.5/-1.7 vs. 4.5+/-1.7,respectively, p¼0.929).However, when SDM was added to the DA, the mean knowledge score increased significantly compared to SOC (5.1Æ1.7 vs. 4.5Æ1.7,respectively, p¼0.030).In addition, patients in the DA+SDM arm were significantly more likely to report talking about having a procedure with their provider compared to the DA alone arm (33%, 30/88, vs. 16%, 16/ 96, respectively, p¼0.011).As it relates to prostate cancer screening, 4% in the SOC arm underwent PSA screening within 1 day compared to 29% in DA alone arm (p¼0.017) and 19% in the DA+SDM arm (p¼0.128).CONCLUSIONS: Providing patients a DA without a personal interaction diminishes the patient's perception of the quality of care.In addition, providing a DA results in patients undergoing PSA-based screening without understanding the consequences of such screening.Particularly with complex issues such as the decision to pursue PSAbased prostate cancer screening, tools cannot substitute for direct interaction with a trusted provider.Instead, a DA should be used to facilitate the shared decision making process, which is critical for improving patient knowledge and understanding.
Source: The Journal of Urology
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2317250340