Decision aid use during post-biopsy consultations for localized prostate cancer

Margaret Holmes-Rovner, Akshay Srikanth, Stephen G Henry, Aisha Langford, David R. Rovner, Angela Fagerlin

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Decision Aids (DAs) effectively translate medical evidence for patients but are not routinely used in clinical practice. Little is known about how DAs are used during patient-clinician encounters. Objective: To characterize the content and communicative function of high-quality DAs during diagnostic clinic visits for prostate cancer. Participants: 252 men newly diagnosed with localized prostate cancer who had received a DA, 45 treating physicians at 4 US Veterans Administration urology clinics. Methods: Qualitative analysis of transcribed audio recordings was used to inductively develop categories capturing content and function of all direct references to DAs (booklet talk). The presence or absence of any booklet talk per transcript was also calculated. Results: Booklet talk occurred in 55% of transcripts. Content focused on surgical procedures (36%); treatment choice (22%); and clarifying risk classification (17%). The most common function of booklet talk was patient corroboration of physicians' explanations (42%), followed by either physician or patient acknowledgement that the patient had the booklet. Codes reflected the absence of DA use for shared decision-making. In regression analysis, predictors of booklet talk were fewer years of patient education (P = .027) and more time in the encounter (P = .027). Patient race, DA type, time reading the DA, physician informing quality and physician age did not predict booklet talk. Conclusions: Results show that good decision aids, systematically provided to patients, appeared to function not to open up deliberations about how to balance benefits and harms of competing treatments, but rather to allow patients to ask narrow technical questions about recommended treatments.

Original languageEnglish (US)
JournalHealth Expectations
DOIs
StateAccepted/In press - 2017

Fingerprint

Decision Support Techniques
Pamphlets
Prostatic Neoplasms
Referral and Consultation
Biopsy
Physicians
United States Department of Veterans Affairs
Urology
Patient Education
Ambulatory Care
Reading
Decision Making
Therapeutics
Regression Analysis

Keywords

  • Decision aids
  • Patient-centred communication
  • Prostate cancer
  • Qualitative research
  • Shared decision-making
  • Veterans

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Holmes-Rovner, M., Srikanth, A., Henry, S. G., Langford, A., Rovner, D. R., & Fagerlin, A. (Accepted/In press). Decision aid use during post-biopsy consultations for localized prostate cancer. Health Expectations. https://doi.org/10.1111/hex.12613

Decision aid use during post-biopsy consultations for localized prostate cancer. / Holmes-Rovner, Margaret; Srikanth, Akshay; Henry, Stephen G; Langford, Aisha; Rovner, David R.; Fagerlin, Angela.

In: Health Expectations, 2017.

Research output: Contribution to journalArticle

Holmes-Rovner, Margaret ; Srikanth, Akshay ; Henry, Stephen G ; Langford, Aisha ; Rovner, David R. ; Fagerlin, Angela. / Decision aid use during post-biopsy consultations for localized prostate cancer. In: Health Expectations. 2017.
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