Treatment decision support for men with prostate cancer and their caregivers
To evaluate the impacts of providing newly diagnosed PC patients and their caregivers with a tablet-based interactive application called the Prostate Health Information Navigator (PHIN) delivered by a community navigator (CN) or providing a National Cancer Institute (NCI) information booklet deliver...
| Main Authors: | , , , |
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| Corporate Author: | |
| Format: | eBook |
| Language: | English |
| Published: |
[Washington, D.C.]
Patient-Centered Outcomes Research Institute (PCORI)
[2019], 2019
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| Series: | Final research report
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| Online Access: | |
| Collection: | National Center for Biotechnology Information - Collection details see MPG.ReNa |
| Summary: | To evaluate the impacts of providing newly diagnosed PC patients and their caregivers with a tablet-based interactive application called the Prostate Health Information Navigator (PHIN) delivered by a community navigator (CN) or providing a National Cancer Institute (NCI) information booklet delivered by a CN. We measured the impacts according to patient outcomes (decisional satisfaction, quality of life, knowledge, decisional self-efficacy, and decisional conflict) and shared decision-making practices (the patient's satisfaction with his preparation for treatment decision-making and involvement in such decision-making).2. To investigate the mechanism by which the PHIN affected patient and caregiver outcomes and shared decision-making.3. To identify men who are most and least likely to benefit from the PHIN. However, some findings were of interest. Overall, both patients and caregivers benefited from education, as evidenced by significant gains in Satisfaction with Decision Scale (SWDS) scores (P < .05). Caregivers learned more about PC with the PHIN than with the NCI booklet. Patients' PC knowledge was strongly correlated with their preparedness to make treatment decisions, and this preparedness was correlated with decisional satisfaction. CONCLUSIONS: Compared with the baseline, caregivers (but not patients) showed statistically significant improvements in the Prostate Cancer Knowledge Questionnaire. Patients and caregivers both experienced significant gains in the SWDS. Neither group experienced significant improvements on the Preparation for Decision Making Scale, and there was no significant benefit from using the PHIN rather than the NCI information booklet. LIMITATIONS: The study's main limitation was the lack of African American men among the participants BACKGROUND: Newly diagnosed prostate cancer (PC) patients are often faced with choosing among a range of treatments. The treatments have a similar 10-year prognosis but with varying impacts on quality of life. Patients who are deciding among treatment options often do not have the amount of information they need. Relevant and appropriate information may be lacking to help men and their caregivers make the best decisions. This study was designed to address the gap in information. We developed a tablet-based interactive knowledge model of PC to provide personalized and patient-centered information on treatment and outcomes for patients and their caregivers. OBJECTIVES: The 3 aims of this community-based randomized control trial were as follows:1. METHODS: We enrolled 191 dyads, and 179 dyads were randomized to 1 of 2 conditions: (1) a tablet-based application (PHIN) delivered by a CN, or (2) an NCI information booklet delivered by a CN. The dyads were recruited from the Moffitt Cancer Center in Tampa, Florida, and from local clinics. Eligible dyads provided informed consent and completed a baseline interview that included the primary and secondary outcome measures as well as potential mediators and moderators. They were contacted for follow-up assessments at postintervention (6 weeks), post-medical consultation (if applicable), 6 months, and 12 months. We evaluated whether variables such as educational attainment, income, race/ethnicity, and comorbidities score interacted with changes over time that could be attributed to the intervention. RESULTS: This study did not find any advantage to using the PHIN rather than the standard printed NCI PC information: Patient and caregiver outcomes were the same in both study arms. |
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| Physical Description: | 1 PDF file (47 pages) illustrations |