78th Annual Meeting Abstracts

Purpose: Deciding among the different treatment options for prostate cancer can be challenging for patients. Systematic reviews have shown improved decision making in patients exposed to decision aids (DAs). The purpose of this study was to integrate a DA into the clinical pathway for newly diagnosed prostate cancer patients and to assess the impact on decision making.
Methods: From September 2007 - February 2008, a prospective cohort of 81 newly diagnosed prostate cancer patients were followed. Prior to consultation with their urologist, patients are mailed a cover letter, informational pamphlets, and a video DA which includes facts about prostate cancer, treatment options, and testimony from patients. After the video, patients complete an online questionnaire that captures clinical and decision making data. A summary report of patient responses is available to the urologist to use during the consultation. Measures include: demographic characteristics, treatment intention, knowledge test of key facts associated with the decision, decisional conflict, and satisfaction with the process.
Results: Of the 81 patients, 53 (66%) indicated they watched the video decision aid.

PrCA Patients	N	Survival Knowledge	Clear Values	Feels Informed	Enough Support	Sure about Treatment Choice
Watched DA	53	75%*	88%*	80%	66%	48%
Did not watch DA	28	36%*	63%*	61%*	64%	42%

* P ≤ 0.05
Preliminary results suggest that patients who watched the video decision aid had a better understanding of the survival rates for prostate cancer (75% vs. 36% correct on knowledge question), were more likely to feel informed and clear about what matters most to them. No differences were observed for patient baseline treatment intention or certainty about their choice. The majority of patients had favorable feedback: 98% felt the information on treatment options was balanced; 92% indicated the length of the DA was “about right”; with an overall rating of “Good” (51%), “Very Good” (24%), or “Excellent” (22%).
Conclusions: For these men, the DA appears to provide information of key facts and help reduce decisional conflict due to unclear values and knowledge gaps. Consequently these patients feel more confident and prepared for their appointment with their physician. Early indications suggest that a video decision aid integrated into routine care for prostate cancer treatment can help improve patient decision making.