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Huber J, Karschuck P, Valdix J, Thomas C, Koch R, Ihrig A, Hölscher T, Krones T, Kessler E, Kliesch S, Linné C, Enders P, Michel MS, Wülfing C, Groeben C. Online decision aid for patients with prostate cancer evaluated by 11 290 patients and 91 urologists in Germany. BJU Int 2024; 134:239-248. [PMID: 38506410 DOI: 10.1111/bju.16329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
OBJECTIVE To evaluate the nationwide online decision aid 'Entscheidungshilfe Prostatakrebs' (established in 2016, >11.000 users and 60 new users/week) for patients with non-metastatic prostate cancer (PCa), from the perspective of patients and urologists. PATIENTS AND METHODS To provide personalised information, the tool collects most of the International Consortium for Health Outcomes Measurement standard set, personal preferences, psychological features, and a validated rating of the tool. To evaluate urologists' opinions, we developed a structured two-page questionnaire. All data were collected anonymously. RESULTS From June 2016 to December 2020, 11 290 patients used the PCa decision aid. Their median (interquartile range [IQR]) age was 67 (61-72) years. The median (IQR) time from initial diagnosis to using the tool was 4 (3-7) weeks. In all, 87.7% of users reported high satisfaction. In a multivariable model, predictors for considering observation were higher knowledge, using the decision aid alone, lower oncological risk, normal erectile function, and respective personal preferences. Of 194 urologists, 91 (47%) had implemented the decision aid in their clinical practice. The urologists' mean (SD) satisfaction score (1 'very good'; 6 'unsatisfactory') with it was 1.45 (0.55), and 92% recommended it. Half of the urologists reported time savings. CONCLUSION Patients and urologists report a very high level of acceptance and satisfaction with this online tool. It offers advantages in shared decision-making and time efficiency. The usage of the decision aid might improve the adoption of active surveillance and watchful waiting when indicated.
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Affiliation(s)
- Johannes Huber
- Department of Urology, Philipps University of Marburg, Marburg, Germany
| | - Philipp Karschuck
- Department of Urology, Philipps University of Marburg, Marburg, Germany
| | - Johanna Valdix
- Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Christian Thomas
- Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Rainer Koch
- Department of Urology, Philipps University of Marburg, Marburg, Germany
| | - Andreas Ihrig
- Division of Psycho-Oncology, Department of General Internal Medicine and Psychosomatic, University Hospital Heidelberg, Heidelberg, Germany
| | - Tobias Hölscher
- Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Tanja Krones
- Institute of Biomedical Ethics and History of Medicine University of Zürich, University Hospital Zürich, Zürich, Switzerland
| | - Elke Kessler
- ASD Concepts GmbH & Co. KG - Institut für Patientenzentrierte Versorgungsformen, Reinheim, Germany
| | - Sabine Kliesch
- Department of Clinical and Surgical Andrology, Centre for Reproductive Medicine and Andrology, University Hospital Münster, Münster, Germany
| | | | - Paul Enders
- Prostate Cancer Patient Support Organization of Germany (BPS), Bonn, Germany
| | | | | | - Christer Groeben
- Department of Urology, Philipps University of Marburg, Marburg, Germany
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Karschuck P, Müller L, Groeben C, Aksoy C, Flegar L, Zacharis A, Baunacke M, Wülfing C, Huber J. [Patient events in German urology: trend towards hybrid formats?]. UROLOGIE (HEIDELBERG, GERMANY) 2024; 63:75-82. [PMID: 37566223 DOI: 10.1007/s00120-023-02162-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/19/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Patient events are an important tool to respond to the increasing need of the public for health information. Through the "patient forum", the German Society of Urology (DGU) is committed to patient information and public relations at its annual congresses. The goal of the study was to evaluate the events from 2017-2019 and to compare them with the first digital patient forum in 2020. MATERIALS AND METHODS Using a two-page standardized questionnaire, we surveyed the visitors of the presence patient forums (presence group = P) of the three annual congresses of the DGU 2017-2019 as well as the users of the digital event 2020 (online group = O). RESULTS We obtained 71 records for 2017-2019 and 18 for 2020. The median age of visitors was 64 years (range 30-89). Males were 66% (P) vs. 83% (O) of participants (p = 0.005). The offer was rated overall as good to very good by both groups, i.e., 1.6 (P) vs. 1.6 (O; p = 0.7) on a scale from 1 to 6 with 1 being the highest rating. In line with the lower interaction in the digital format, the possibility to ask questions was rated worse with 1.5 (P) vs. 2.8 (O; p = 0.003). When asked about the desired future event format, two-thirds of the users of the digital patient forum were in favor of a hybrid event on-site and online. CONCLUSION Patient events are suitable means of communication for the public and are rated well by visitors. In particular, interaction with experts is highly valued. Face-to-face formats are associated with a high logistical effort and high costs, and their reach is limited. In the future, hybrid formats could be a reasonable alternative, as they combine the advantages of online and face-to-face formats.
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Affiliation(s)
- Philipp Karschuck
- Klinik für Urologie, Philipps-Universität Marburg, Baldingerstraße, 35033, Marburg, Deutschland.
| | - Laura Müller
- Klinik für Urologie, Philipps-Universität Marburg, Baldingerstraße, 35033, Marburg, Deutschland
| | - Christer Groeben
- Klinik für Urologie, Philipps-Universität Marburg, Baldingerstraße, 35033, Marburg, Deutschland
| | - Cem Aksoy
- Klinik für Urologie, Philipps-Universität Marburg, Baldingerstraße, 35033, Marburg, Deutschland
| | - Luka Flegar
- Klinik für Urologie, Philipps-Universität Marburg, Baldingerstraße, 35033, Marburg, Deutschland
| | - Aristeidis Zacharis
- Klinik für Urologie, Philipps-Universität Marburg, Baldingerstraße, 35033, Marburg, Deutschland
| | - Martin Baunacke
- Klinik und Poliklinik für Urologie, Technische Universität Dresden, Dresden, Deutschland
| | | | - Johannes Huber
- Klinik für Urologie, Philipps-Universität Marburg, Baldingerstraße, 35033, Marburg, Deutschland
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Lunger L, Meissner VH, Kopp BCG, Dinkel A, Schiele S, Ankerst DP, Gschwend JE, Herkommer K. Prevalence and determinants of decision regret in long-term prostate cancer survivors following radical prostatectomy. BMC Urol 2023; 23:139. [PMID: 37612591 PMCID: PMC10464370 DOI: 10.1186/s12894-023-01311-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 08/16/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Patients with localized prostate cancer (PC) are faced with a wide spectrum of therapeutic options at initial diagnosis. Following radical prostatectomy (RP), PC patients may experience regret regarding their initial choice of treatment, especially when oncological and functional outcomes are poor. Impacts of psychosocial factors on decision regret, especially after long-term follow-up, are not well understood. This study aimed to investigate the prevalence and determinants of decision regret in long-term PC survivors following RP. METHODS 3408 PC survivors (mean age 78.8 years, SD = 6.5) from the multicenter German Familial PC Database returned questionnaires after an average of 16.5 (SD = 3.8) years following RP. The outcome of decision regret concerning the initial choice of RP was assessed with one item from the Decision Regret Scale. Health-related quality of life (HRQoL), PC-anxiety, PSA-anxiety, as well as anxiety and depressive symptoms were considered for independent association with decision regret via multivariable logistic regression. RESULTS 10.9% (373/3408) of PC survivors reported decision regret. Organ-confined disease at RP (OR 1.39, 95%CI 1.02-1.91), biochemical recurrence (OR 1.34, 1.00-1.80), low HRQoL (OR 1.69,1.28-2.24), depressive symptoms (OR 2.32, 1.52-3.53), and prevalent PSA anxiety (OR 1.88,1.17-3.01) were significantly associated with increased risk of decision regret. Shared decision-making reduced the odds of decision regret by 40% (OR 0.59, 0.41-0.86). CONCLUSIONS PC survivors may experience decision regret even after 16 years following RP. Promoting shared decision-making in light of both established and novel, potentially less invasive treatments at initial diagnosis may help mitigate long-term regret. Awareness regarding patients showing depressive symptoms or PSA anxiety should be encouraged to identify patients at risk of decision regret in need of additional psychological support.
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Affiliation(s)
- Lukas Lunger
- Department of Urology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany
| | - Valentin H Meissner
- Department of Urology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany
| | - Benedikt C G Kopp
- Department of Urology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany
| | - Andreas Dinkel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Stefan Schiele
- Department of Urology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany
| | - Donna P Ankerst
- Departments of Mathematics and Life Science Systems, Munich Data Science Institute, Technical University of Munich, Garching, Germany
| | - Jürgen E Gschwend
- Department of Urology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany
| | - Kathleen Herkommer
- Department of Urology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany.
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Horn J, Tostmann R, Dobel C, Löhler J, Guntinas-Lichius O. Die Perspektive der Patienten auf die HNO-Heilkunde – eine deutschlandweite Befragung. Laryngorhinootologie 2022. [PMID: 36543218 DOI: 10.1055/a-1970-6558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Zusammenfassung
Hintergrund Patientenorientierung zur Entscheidungsfindung für die beste Behandlung, aber auch die Patientenbeteiligung an Forschungsprojekten wird mehr gefordert.
Methoden In einer multizentrischen prospektiven Querschnittsstudie haben HNO-Patienten im Juni 2021 in 27 HNO-Praxen, 18 HNO-Kliniken und 14 Universitäts-HNO-Kliniken die Möglichkeit, einen Laien-gerechten Fragebogen mit Fragen zur Patientenorientierung, evidenzbasierten Medizin, Forschungsbedarf und Gesundheitskompetenz ausgefüllt.
Ergebnisse 2023 Patientenantworten (46% weiblich; 49% 46–75 Jahre alt; 40% in HNO-Praxis) wurden ausgewertet. Als HNO-Erkrankung war am häufigsten eine Sinnesstörung (16,8%) oder ein Tumor (12,7%) angegeben. Gemeinsam bei Therapieentscheidungen zu agieren, wurde als Entscheidungsprozess favorisiert (43,5%). Genügend Zeit für das Gespräch wurde als wichtigstes Element der Beziehung genannt (15,8%). Die meisten Teilnehmer fühlten sich über die Behandlungsschritte gut informiert (42,4%). Bei der elektronischen Suche wurden vor allem allgemeine Suchmaschinen verwendet (50,3%). Drei Viertel der Teilnehmer (73,7%) hatte noch nie an einer Studie teilgenommen. Etwa zwei Drittel (62,8%) konnten sich das auch für die Zukunft nicht vorstellen. Faktoren wie Geschlecht, Alter, Schulbildung oder Ort der Befragung waren mit anderem Antwortverhalten assoziiert.
Diskussion Der Wunsch nach Patientenorientierung ist auch bei HNO-Patienten hoch und von den HNO-Ärzten in Praxis und Klinik auch häufig umgesetzt. Insbesondere Patienten mit geringer Schulbildung sollten bei der Planung und Durchführung von Studien stärker eingebunden werden, um Partizipationsmöglichkeiten gemäß den Empfehlungen der Förderinstitutionen zu geben.
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Affiliation(s)
- Josephine Horn
- HNO-Klinik, Universitätsklinikum Jena, Jena, Deutschland
| | - Ralf Tostmann
- Studienzentrum UMG, Georg-August-Universität Göttingen Universitätsmedizin, Gottingen, Deutschland
| | | | - Jan Löhler
- HNO-Praxis Bad Bramstedt, Bad Bramstedt, Deutschland
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Ihrig A, Maatouk I, Friederich HC, Baunacke M, Groeben C, Koch R, Thomas C, Huber J. The Treatment Decision-making Preferences of Patients with Prostate Cancer Should Be Recorded in Research and Clinical Routine: a Pooled Analysis of Four Survey Studies with 7169 Patients. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:675-682. [PMID: 32940881 PMCID: PMC9205804 DOI: 10.1007/s13187-020-01867-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/02/2020] [Indexed: 05/13/2023]
Abstract
Different patients want to take different roles in the treatment decision-making process; these roles can be classified as passive, collaborative, and active. The aim of this study was to investigate the correlation between decision-making preferences among patients with prostate cancer and personal, disease-related, and structural factors. In four survey studies, we asked 7169 prostate cancer patients about their decision-making preferences using the Control Preferences Scale (CPS) and collected clinical, psychological, and quality-of-life measures. Most patients (62.2%) preferred collaborative decision-making, while 2322 (32.4%) preferred an active role, and only 391 (5.5%) preferred a passive role. Age (p < 0.001), data collection mode (p < 0.001), peer-to-peer support (p = 0.018), treatment status (p < 0.001), performed or planned radical prostatectomy (p < 0.001), metastatic disease (p = 0.001), and quality of life (p < 0.001) showed significant associations with patients' preferred decision-making roles. Oncologic risk group, anxiety, and depression were not significant in the model. In particular, younger prostate cancer patients with higher quality of life completing an online survey want to play a more active role in treatment decision-making. Before treatment has started, patients tend to prefer collaborative decision-making. Few prostate cancer patients in Germany prefer a passive role. These patients are mostly older patients, patients with a metastatic disease, and patients who have opted for prostatectomy. Whether this finding reflects a generational effect or a tendency by age group and disease phase should be investigated. Further research is also needed to describe the causalities of these relationships. The CPS offers valuable information for personal counselling and should be applied in clinical routine. In a large group of patients with prostate cancer, we found that there is a strong desire for joint decision-making with the physician before the actual treatment. Especially younger men, men with active online behaviour, and men with a high quality of life want to be actively involved in therapy decision-making processes.
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Affiliation(s)
- Andreas Ihrig
- Division of Psychooncology, Department of General Internal Medicine and Psychosomatic, University Hospital of Heidelberg, INF 410, 69120, Heidelberg, Germany.
| | - I Maatouk
- Division of Psychooncology, Department of General Internal Medicine and Psychosomatic, University Hospital of Heidelberg, INF 410, 69120, Heidelberg, Germany
| | - H C Friederich
- Division of Psychooncology, Department of General Internal Medicine and Psychosomatic, University Hospital of Heidelberg, INF 410, 69120, Heidelberg, Germany
| | - M Baunacke
- Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - C Groeben
- Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - R Koch
- Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - C Thomas
- Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - J Huber
- Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
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Ihrig A, Renner T, Muck T, Maatz P, Borkowetz A, Keck B, Maatouk I, Wirth MP, Huber J. Online support groups offer low-threshold backing for family and friends of patients with prostate cancer. Eur J Cancer Care (Engl) 2018; 28:e12982. [PMID: 30569592 DOI: 10.1111/ecc.12982] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 11/05/2018] [Accepted: 11/14/2018] [Indexed: 02/05/2023]
Abstract
A prostate cancer diagnosis affects not only the patients but also their family and friends. We performed a secondary analysis of a survey of users of the largest German online support group (OSG) for prostate cancer. We collected socio-demographic, psychological and disease-related data over a three-month period in 2013. Among 769 participants with a complete questionnaire, 686 were patients, and 83 were family members and friends of other patients. The family and friends group comprised 33% spouses, 31% children and 36% people with other relationships to the patient ("others"). Compared to the patient group, the family and friends group showed higher scores for anxiety and depression and described a higher rate of metastatic disease in the patients with whom they had a relationship. The children of patients showed the highest psychological burden based on their scores for anxiety and depression. Only 7% of spouses and none of the children attended face-to-face support groups, compared to 70% of people in the "others" group. OSGs offer low-threshold support for family members and friends; specifically, they meet the needs of spouses and children who do not attend face-to-face support groups. To improve counselling efforts, physicians should be aware of this online resource.
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Affiliation(s)
- Andreas Ihrig
- Division of Psychooncology, Department of General Internal Medicine and Psychosomatic, University of Heidelberg, Heidelberg, Germany
| | - Theresa Renner
- Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Tanja Muck
- Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Philipp Maatz
- Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Angelika Borkowetz
- Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Bastian Keck
- Department of Urology, University Hospital Erlangen, Erlangen, Germany
| | - Imad Maatouk
- Division of Psychooncology, Department of General Internal Medicine and Psychosomatic, University of Heidelberg, Heidelberg, Germany
| | - Manfred P Wirth
- Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Johannes Huber
- Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
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["Dr. Google"-information-seeking behavior and disease-specific anxiety among men with localized prostate cancer]. Urologe A 2018; 58:1050-1056. [PMID: 30178295 DOI: 10.1007/s00120-018-0769-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND OBJECTIVE After the diagnosis of localized prostate cancer (LPCa), many men seek additional information about their disease. However, it is not yet proven how different sources of information influence uncertainty and disease-specific anxiety. The aim of this study is to investigate to what extent different types of information sources, the number of used sources and the perceived level of information are predictive of disease-specific anxiety. MATERIALS AND METHODS Men with LPCa (N = 292; n = 150 radical prostatectomy, n = 142 active surveillance) completed questionnaires assessing sociodemographic variables, number and type of sources of information used, perceived level of information, and disease-specific anxiety. The association of information-seeking behavior with anxiety was tested using moderated sequential multiple regression. RESULTS Men were 70 ± 7.2 years old and the survey was taken 47.9 ± 15.4 months after decision for therapy. The multiple regression analysis showed that, after controlling for potential covariates, internet usage (β = 3.28; p > 0.001), number of sources (β = 1.09; p > 0.01) and a lower level of informedness (β = 4.49; p > 0.001) independently predicted variability of anxiety. In addition, the 3‑way interaction (β = 2.03; p > 0.05) accounted for a significant proportion of variance. Overall, the model explained 30% of the criterion variance. CONCLUSIONS Our results show that many men with LPCa already use the internet as a source of information and that this online search is associated with increased disease-specific anxiety. It may be possible to reduce disease-specific anxiety and uncertainty if physicians advise their patients on the selection of reliable online sources.
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Baunacke M, Groeben C, Borgmann H, Salem J, Kliesch S, Huber J. Andrology on the Internet: Most wanted, controversial and often primary source of information for patients. Andrologia 2017; 50. [DOI: 10.1111/and.12877] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2017] [Indexed: 11/29/2022] Open
Affiliation(s)
- M. Baunacke
- Department of Urology; TU Dresden; Dresden Germany
| | - C. Groeben
- Department of Urology; TU Dresden; Dresden Germany
| | - H. Borgmann
- Department of Urology; University Hospital Mainz; Mainz Germany
| | - J. Salem
- Department of Urology; University Hospital Cologne; Cologne Germany
| | - S. Kliesch
- Centre of Andrology and Reproductive Medicine; University of Muenster; Muenster Germany
| | - J. Huber
- Department of Urology; TU Dresden; Dresden Germany
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The effect of an online support group on patients׳ treatment decisions for localized prostate cancer: An online survey. Urol Oncol 2017; 35:37.e19-37.e28. [DOI: 10.1016/j.urolonc.2016.09.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 07/14/2016] [Accepted: 09/27/2016] [Indexed: 11/23/2022]
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12
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Groeben C, Baunacke M, Borkowetz A, Kliesch S, Wülfing C, Ihrig A, Huber J. [Decision aids for patients are widely accepted by German urologists : A survey among members of the German Society of Urology (DGU) and the Federation of German Urologists (BDU)]. Urologe A 2016; 55:784-91. [PMID: 26969330 DOI: 10.1007/s00120-016-0054-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Treatment decision making remains a complex task for localized prostate cancer. Decision aids for patients can support the medical consultation. However, it is not known if German urologists accept decision aids for patients. Comparative data exist from a current survey among american urologists and radio oncologists. MATERIALS AND METHODS From October through November 2014 we conducted an online survey consisting of 11 multiple-choice questions and an optional free text commentary among the members of DGU and BDU. All data was processed anonymously. We received 464 complete responses for a 6.6 % return rate. For group comparison we applied the Chi2-test. RESULTS Respondents' median age was 50 (range 26-87) years and 15 % were female. 7 % were residents, 31 % employed at a clinic, and 57 % in private practice. Due to the low response rate of younger colleagues the results were not representative for the basic population. Regardless of age (p = 0.2) and professional environment (p = 1) shared decision making was preferred by 89 %. When counseling their patients with localized prostate cancer 20 % relied exclusively on conversation. To support their conversation 63 % used print media, 49 % decision aids, 33 % contact offers to support groups, 24 % Internet resources and 13 % video material. From using decision aids 86 % expected positive effects for patients and 78 % for physicians (p = 0.017). 15 % expected a change of the treatment decision. 77 % would motivate their patients to use a decision aid. CONCLUSIONS In comparison to the opinion of american urologists and radio oncologists the acceptance of decision aids for patients among German urologists is significantly higher.
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Affiliation(s)
- C Groeben
- Klinik und Poliklinik für Urologie, Medizinische Fakultät Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - M Baunacke
- Klinik und Poliklinik für Urologie, Medizinische Fakultät Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - A Borkowetz
- Klinik und Poliklinik für Urologie, Medizinische Fakultät Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - S Kliesch
- Centrum für Reproduktionsmedizin und Andrologie, Abteilung für Klinische Andrologie, Universitätsklinikum Münster, Münster, Deutschland
| | - C Wülfing
- Abteilung für Urologie, Asklepios Klinik Altona, Hamburg, Deutschland
| | - A Ihrig
- Sektion Psychoonkologie, Klinik für Allgemeine Innere Medizin und Psychosomatik, Universitätsklinik Heidelberg, Heidelberg, Deutschland
| | - J Huber
- Klinik und Poliklinik für Urologie, Medizinische Fakultät Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
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Ernstmann N, Jaeger J, Kowalski C, Pfaff H, Weißbach L. [Elderly prostate cancer patients: patient information and shared decision making]. Urologe A 2014; 52:847-52. [PMID: 23328778 DOI: 10.1007/s00120-012-3071-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Some data exist on information and decision-making preferences of elderly prostate cancer patients but little is known about whether communication needs are being met in urological practice. Therefore, it was the aim of this study to examine the information and shared decision-making experiences of prostate cancer patients over 75 years old. MATERIALS AND METHODS The HAROW (hormonal therapy, active surveillance, radiation, operation and watchful waiting) study is a prospective, observational study designed to collect clinical data and patient reported outcome of different treatment options for patients newly diagnosed with localized prostate cancer under real conditions. At 6-month intervals general clinical data, PROs (e.g. quality of life, quality of physician-patient interaction) and individual costs are documented. Data from 2,482 patients at 4 time points from T0 (initial diagnosis) to T3 (24 months follow-up) were analyzed. RESULTS T-tests and χ(2)-tests revealed no significant differences in terms of shared decision-making and information to different treatment options between patients aged over 75 years old and the rest of the sample. Regarding information on self-help groups, rehabilitation options and a second medical opinion, there were significant differences between prostate cancer patient age groups: patients aged over 75 years old received less information on these aspects at all points in time. CONCLUSION Patients at all ages feel activated by urologists and are informed about different treatment options. However, there is room for improvement in terms of informing especially elderly prostate cancer patients about rehabilitation, second medical opinions and self-help groups. Special information tools and decision aids for prostate cancer patients aged over 75 years old should be developed and implemented to meet the specific information needs.
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Affiliation(s)
- N Ernstmann
- Institut für Medizinsoziologie, Versorgungsforschung und Rehabilitationswissenschaft, Universität zu Köln (IMVR), Eupener Straße 129, 50933 Köln, Deutschland.
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