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Kwon DH, Karthikeyan S, Chang A, Borno HT, Koshkin VS, Desai A, Bose R, Friedlander T, Rodvelt T, Li P, Small EJ, Aggarwal RR, Belkora J. Mobile Audio Recording Technology to Promote Informed Decision Making in Advanced Prostate Cancer. JCO Oncol Pract 2021; 18:e648-e658. [PMID: 34932386 DOI: 10.1200/op.21.00480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Men with metastatic castration-resistant prostate cancer increasingly encounter complex treatment decisions. Consultation audio recordings and summaries promote patient informed decision making but are underutilized. Mobile recording software applications may increase access. Little is known regarding the feasibility of implementation in clinical encounters. METHODS We conducted a mixed-methods pilot study in men with progressive metastatic castration-resistant prostate cancer. We instructed patients to use a mobile software application to record an oncology visit. Patients could share the recording with our patient scribing program to receive a written summary. We assessed feasibility and acceptability with postvisit surveys. We measured patient-reported helpfulness of the intervention in decision making and change in Decisional Conflict Scale-informed subscale. We conducted semistructured interviews to explore implementation and analyzed transcripts using thematic analysis. RESULTS Across 20 patients, 18 (90%) recorded their visits. Thirteen of 18 (72%) listened to the recording, and 14 of 18 (78%) received a summary. Eighteen of 20 (90%) visits were telehealth. Fourteen patients (70% of all 20; 78% of 18 question respondents) found the application easy to use. Nine patients (50% of 18 recording patients; 90% of 10 question respondents) reported that the recording helped treatment decision making. Decisional conflict decreased from baseline to 1-week postvisit (47.4-28.5, P < .001). Interviews revealed benefits, facilitators, contextual factors, and technology and patient-related barriers to recordings and summaries. CONCLUSION In this single-institution academic setting, a mobile application for patients to record consultations was a feasible, acceptable, and potentially valued intervention that improved decision making in the telehealth setting. Studies in larger, diverse populations are needed.
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Affiliation(s)
- Daniel H Kwon
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA
| | - Sneha Karthikeyan
- Department of Surgery, University of California, San Francisco, San Francisco, CA
| | - Alison Chang
- Department of Surgery, University of California, San Francisco, San Francisco, CA
| | - Hala T Borno
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA.,Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | - Vadim S Koshkin
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA.,Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | - Arpita Desai
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA.,Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | - Rohit Bose
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA.,Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | - Terence Friedlander
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA.,Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | - Tammy Rodvelt
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | - Patricia Li
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | - Eric J Small
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA.,Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | - Rahul R Aggarwal
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA.,Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | - Jeffrey Belkora
- Department of Surgery, University of California, San Francisco, San Francisco, CA.,Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA.,Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA
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Matheson L, Nayoan J, Rivas C, Brett J, Wright P, Butcher H, Jordan P, Gavin A, Glaser A, Mason M, Wagland R, Watson E. Strategies for living well with hormone-responsive advanced prostate cancer-a qualitative exploration. Support Care Cancer 2020; 29:1317-1325. [PMID: 32632762 DOI: 10.1007/s00520-020-05594-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 06/23/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE Due to recent treatment advances, men are increasingly living longer with advanced prostate cancer (PCa). This study sought to understand men's experiences of living with and adjusting to advanced hormone-responsive PCa and how this influenced their quality of life (QoL), in order to highlight how support could be optimized. METHODS Participants were recruited through a UK wide survey-the 'Life After Prostate Cancer Diagnosis' study. In-depth telephone interviews were conducted with 24 men (aged 46-77 years) with advanced (stage IV) hormone-responsive PCa diagnosed 18-42 months previously. Thematic analysis was undertaken using a framework approach. RESULTS Most participants perceived their QoL to be relatively good, which was influenced by the following factors (enablers to 'living well' with PCa): a sense of connectedness to others, engagement in meaningful activities, resources (social, cognitive, financial), ability to manage uncertainty, utilization of adjustment strategies and support, communication and information from health professionals. Barriers to 'living well' with PCa were often the converse of these factors. These also included more troublesome PCa-related symptoms and stronger perceptions of loss and restriction. CONCLUSIONS In our study, men living with advanced hormone-responsive PCa often reported a good QoL. Exploring the influences on QoL in men with advanced PCa indicates how future interventions might improve the QoL of men who are struggling. Further research is required to develop and test interventions that enhance QoL for these men.
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Affiliation(s)
- Lauren Matheson
- Oxford School of Nursing and Midwifery, Oxford Brookes University, Oxford, OX3 0FL, UK
| | - Jo Nayoan
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, UK.,European Centre for Environment and Human Health (ECEHH), University of Exeter, Truro, TR1 3HD, UK
| | - Carol Rivas
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, UK.,Department of Social Science, University College London (UCL), London, WC1H 0NR, UK
| | - Jo Brett
- Oxford School of Nursing and Midwifery, Oxford Brookes University, Oxford, OX3 0FL, UK
| | - Penny Wright
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | | | | | - Anna Gavin
- Northern Ireland Cancer Registry, Centre for Public Health, Queen's University Belfast, Belfast, BT12 6BJ, UK
| | - Adam Glaser
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, Leeds, LS2 9JT, UK
| | - Malcolm Mason
- Scool of Medicine, Cardiff University, Cardiff, CF14 2TL, UK
| | - Richard Wagland
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, UK
| | - Eila Watson
- Oxford School of Nursing and Midwifery, Oxford Brookes University, Oxford, OX3 0FL, UK.
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Litzkendorf S, Frank M, Babac A, Rosenfeldt D, Schauer F, Hartz T, Graf von der Schulenburg JM. Use and importance of different information sources among patients with rare diseases and their relatives over time: a qualitative study. BMC Public Health 2020; 20:860. [PMID: 32503483 PMCID: PMC7275578 DOI: 10.1186/s12889-020-08926-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 05/17/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Finding reliable information on one of more than 7000 rare diseases is a major challenge for those affected. Since rare diseases are defined only by the prevalence criterion, a multitude of heterogeneous diseases are included. Common to all, however, are difficulties regarding information access. Even though various quantitative studies have analyzed the use of different information sources for specific rare diseases, little is known about the use of information sources for different rare diseases, how users rate these information sources based on their experiences, and how the use and importance of these information sources change over time. METHODS Fifty-five patients with a variety of rare diseases and 13 close relatives participated in qualitative interviews. For these interviews, a semi-structured guideline was developed, piloted, and revised. Data analysis involved a qualitative content analysis developed by Philipp Mayring. RESULTS The participants considered internet as the most important and widespread information source, especially for early information. Although patients have difficulty dealing with information obtained online, they consider online searching a quick and practical option to gather information. During the course of the disease, personal contact partners, especially self-help associations and specialized doctors, become more important. This is also because information provided online is sometimes insufficiently detailed to answer their information needs, which can be complemented by information from doctors and self-help. CONCLUSIONS People rarely use just one type of source, but rather refer to different sources and informants. The source used depends on the type of information sought as well as other person-related factors such as preexisting knowledge and the disease stage. To improve people's information searching and connect them with medical specialists in rare diseases, a central information portal on rare diseases might be a suitable access point to provide free and quality assured information for patients, caregivers, and physicians. This would allow not only patients but also doctors to find quality assured information on symptoms and therapies as well as patient associations and specialized doctors.
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Affiliation(s)
- Svenja Litzkendorf
- Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Otto-Brenner-Straße 7, 30159, Hannover, Germany.
| | - Martin Frank
- Faculty of Public Health Services, Ostfalia University of Applied Science, Rothenfelder Straße 10, 38440, Wolfsburg, Germany
| | - Ana Babac
- Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Otto-Brenner-Straße 7, 30159, Hannover, Germany
| | - Daniel Rosenfeldt
- Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Otto-Brenner-Straße 7, 30159, Hannover, Germany
| | - Franziska Schauer
- Department of Dermatology, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 7, 79104, Freiburg, Germany
| | - Tobias Hartz
- Clinical Cancer Registry of Lower Saxony, Sutelstraße 2, 30659, Hannover, Germany
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Catt S, Matthews L, May S, Payne H, Mason M, Jenkins V. Patients' and partners' views of care and treatment provided for metastatic castrate-resistant prostate cancer in the UK. Eur J Cancer Care (Engl) 2019; 28:e13140. [PMID: 31475410 DOI: 10.1111/ecc.13140] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 06/17/2019] [Accepted: 07/24/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Documentations of the experiences of patients with advanced prostate cancer and their partners are sparse. Views of care and treatment received for metastatic castrate-resistant prostate cancer (mCRPC) are presented here. METHODS Structured interviews conducted within 14 days of a systemic therapy for mCRPC starting and 3 months later explored the following: treatment decisions, information provision, perceived benefits and harms of treatment, and effects of these on patients' and partners' lives. RESULTS Thirty-seven patients and 33 partners recruited from UK cancer centres participated. The majority of patients (46%) reported pain was their worst symptom and many wanted to discuss its management (baseline-50%; 3 months-33%). Patients and partners believed treatment would delay progression (>75%), improve wellbeing (33%), alleviate pain (≈12%) and extend life (15% patients, 36% partners). At 3 months, most men (42%) said fatigue was the worst treatment-related side effect (SE), 27% experienced unexpected SEs and 54% needed help with SEs. Most patients received SE information (85% written; 75% verbally); many additionally searched the Internet (33% patients; 55% partners). Only 54% of patients said nurse support was accessible. CONCLUSION Pain and other symptom management are not optimal. Increased specialist nurse provision and earlier palliative care links are needed. Dedicated clinics may be justified.
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Affiliation(s)
- Susan Catt
- Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Brighton, UK
| | - Lucy Matthews
- Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Brighton, UK
| | - Shirley May
- Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Brighton, UK
| | - Heather Payne
- Department of Oncology, University College Hospital London, London, UK
| | - Malcolm Mason
- Division of Cancer and Genetics, School of Medicine, Cardiff University, Velindre Hospital, Whitchurch, UK
| | - Valerie Jenkins
- Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Brighton, UK
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Chambers SK, Hyde MK, Laurie K, Legg M, Frydenberg M, Davis ID, Lowe A, Dunn J. Experiences of Australian men diagnosed with advanced prostate cancer: a qualitative study. BMJ Open 2018; 8:e019917. [PMID: 29455168 PMCID: PMC5855292 DOI: 10.1136/bmjopen-2017-019917] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE To explore men's lived experience of advanced prostate cancer (PCa) and preferences for support. DESIGN Cross-sectional qualitative study applying open-ended surveys and interviews conducted between June and November 2016. Interviews audio-recorded and transcribed verbatim and analysed from an interpretive phenomenological perspective. SETTING Australia, nation-wide. PARTICIPANTS 39 men diagnosed with advanced PCa (metastatic or castration-resistant biochemical regression) were surveyed with 28 men subsequently completing a semistructured in depth telephone interview. RESULTS Thematic analysis of interviews identified two organising themes: lived experience and supportive care. Lived experience included six superordinate themes: regret about late diagnosis and treatment decisions, being discounted in the health system, fear/uncertainty about the future, acceptance of their situation, masculinity and treatment effects. Supportive care included five superordinate themes: communication, care coordination, accessible care, shared experience/peer support and involvement of their partner/family. CONCLUSIONS Life course and the health and social context of PCa influence men's experiences of advanced disease. Multimodal interventions integrating peer support and specialist nurses are needed that more closely articulate with men's expressed needs.
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Affiliation(s)
- Suzanne K Chambers
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
- Cancer Research Centre, Cancer Council Queensland, Brisbane, Queensland, Australia
- Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Sydney, New South Wales, Australia
- Prostate Cancer Foundation of Australia, Sydney, New South Wales, Australia
- Institute for Resilient Regions, University of Southern Queensland, Toowoomba, Queensland, Australia
- Health & Wellness Institute, Edith Cowan University, Perth, Western Australia, Australia
| | - Melissa K Hyde
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
- Cancer Research Centre, Cancer Council Queensland, Brisbane, Queensland, Australia
| | - Kirstyn Laurie
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
- Cancer Research Centre, Cancer Council Queensland, Brisbane, Queensland, Australia
| | - Melissa Legg
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
- Cancer Research Centre, Cancer Council Queensland, Brisbane, Queensland, Australia
| | - Mark Frydenberg
- Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Sydney, New South Wales, Australia
- Department of Urology, Monash Health, Melbourne, Victoria, Australia
- Department of Surgery, Faculty of Medicine, Monash University, Melbourne, Victoria, Australia
| | - Ian D Davis
- Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Sydney, New South Wales, Australia
- Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Anthony Lowe
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
- Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Sydney, New South Wales, Australia
- Prostate Cancer Foundation of Australia, Sydney, New South Wales, Australia
| | - Jeff Dunn
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
- Cancer Research Centre, Cancer Council Queensland, Brisbane, Queensland, Australia
- Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Sydney, New South Wales, Australia
- Institute for Resilient Regions, University of Southern Queensland, Toowoomba, Queensland, Australia
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