Login to Access Video or Poster Abstract: MP57-07
Sources of Funding: AHRQ 1K12HS022990-01 (DP)

Introduction

Recent therapeutic advances have resulted in a rapidly growing population of advanced prostate cancer survivors. Guidelines do not definitively direct treatment choice in the advanced prostate cancer setting, and communication and patient preferences are critical to therapeutic decision making. We sought to identify factors men consider when making treatment decisions for advanced prostate cancer and to determine any differences based on demographics.

Methods

We completed 3 focus groups of men with metastatic prostate cancer (mPC) to identify factors considered by patients facing treatment decisions. Between 6/1/15 and 9/29/16, 96 men with mPC completed surveys developed using the focus group data to define the importance of identified factors during their current mPC treatment decision. We used frequencies and relative frequencies to describe treatment decision factors, and proportional odds models with robust standard errors to assess the association between treatment decision factors, clinical characteristics, and sociodemographic factors. _x000D_

Results

Overall, the three highest factors with which men had strong agreement on treatment choice were 1-feeling well enough to spend quality time with family (70.3%), 2-being able to die in a manner consistent with their wishes (69.4%), and 3-liking when the physician gives choices for treatment (67.6%). The three factors with the lowest percentage of strong agreement were 1-accepting severe side affects to avoid being debilitated (33.6%), 2-finding a treatment that minimizes pain (23.4%), and 3-avoiding financial trouble due to treatment (2%). Avoiding financial trouble due to treatment was the least important factor regardless of race, marital status, employment status, self-reported health status, or age.

Conclusions

Personal factors such as quality of life, time with family and being offered treatment choices appear to have the strongest impact on patient decision making for treatment of mPC. While financial concerns were the least important factor, this may be a reflection of an insured population. Efforts to understand patient considerations during treatment for advanced prostate cancer should be made in clinical settings and further investigated.

Funding

AHRQ 1K12HS022990-01 (DP)