Abstract: PD47-07
Sources of Funding: none

Introduction

Decision aids (DAs) support shared decision making for the treatment of localized prostate cancer by providing balanced evidence based information, eliciting preferences and by structuring the decision making process. Studies have shown that the use of a DA may increase minimal/non-invasive treatment options. However, the current literature is uncertain about the effect on treatment choice in localized prostate cancer using DAs. Our objective is to study the effect of a preference sensitive web based DA on treatment decision making.

Methods

A randomized cluster controlled trial was performed among 18 hospitals between 2014-2016. _x000D_ In the intervention arm (nine hospitals) the DA was offered following diagnosis (N=332). Patients in the control arm (another nine hospitals) received care and information as usual (N=128). After treatment decision-making but before treatment start, patients in both arms received a questionnaire measuring treatment choice, decisional conflict and knowledge. Analyses were performed using t-tests, ANOVA and Pearson correlations._x000D_

Results

Response rate was 72% (intervention N=273, control N=109). No differences were found in PSA and Gleason score between groups. The decision aid led to more patients choosing active surveillance (AS) in comparison with standard information (28% vs. 17%, P=0.03). In the control arm we found significantly more external beam radiotherapy (EBRTx) (16% vs 8%, P=0.02) and brachytherapy (BT) ( 33% vs. 19%, P=0.005). No differences were found in decisional conflict and knowledge. One in five patients indicated to prefer a decision aid in a paper form instead of online.

Conclusions

Patients made different treatment choices after DA use. The online DA supported shared decision making and this may lead to significantly more AS. More radiotherapy was found in the control arm. The decision aid did not lead to more decisional conflict. However, a minority of the patients prefers a paper form of the decision aid. The most optimal DA form needs to be determined. We currently collect post-treatment measures to determine regret and treatment satisfaction levels.

Funding

none