PURPOSE: Many clinicians lack resources to engage patients in shared decision making for prostate cancer screening. We sought to evaluate whether previsit educational decision aids facilitate shared decision making. METHODS: This randomized controlled study compared a Web-based and a paper-based decision aid with no previsit education. Men aged 50 to 70 years undergoing a health maintenance examination at a large family practice were enrolled. The primary outcome was patient-reported level of control over the decision to be screened. Secondary outcomes included frequency of screening, patient knowledge, decisional conflict, and time spent discussing screening. RESULTS: A total of 497 men participated (75 control, 196 brochure, 226 Web site). Patients exposed to either aid were no more likely than control patients to report a collaborative decision: 36% of patients in each group reported equally sharing decision responsibility. Exposure to either decision aid increased patients' involvement in decision making compared with the control condition (Web site, P = .03; brochure, P = .03). Only 46% of control patients reported an active decision-making role, compared with 56% of Web site and 54% of brochure patients. Patients exposed to a decision aid answered a greater percentage of knowledge questions correctly (54% control vs 69% Web site, P <.001, and vs 69% brochure, P <.001) and were less likely to be screened (94% control vs 86% Web site, P = .06, and vs 85% brochure, P = .04). CONCLUSIONS: Patients in the decision aid groups were more informed and more engaged in the screening decision than their control counterparts. Exposure did not promote shared decision-making control, however. Whether shared decision making is the ideal model and how to measure its occurrence are subjects for further research.
RCT Entities:
PURPOSE: Many clinicians lack resources to engage patients in shared decision making for prostate cancer screening. We sought to evaluate whether previsit educational decision aids facilitate shared decision making. METHODS: This randomized controlled study compared a Web-based and a paper-based decision aid with no previsit education. Men aged 50 to 70 years undergoing a health maintenance examination at a large family practice were enrolled. The primary outcome was patient-reported level of control over the decision to be screened. Secondary outcomes included frequency of screening, patient knowledge, decisional conflict, and time spent discussing screening. RESULTS: A total of 497 men participated (75 control, 196 brochure, 226 Web site). Patients exposed to either aid were no more likely than control patients to report a collaborative decision: 36% of patients in each group reported equally sharing decision responsibility. Exposure to either decision aid increased patients' involvement in decision making compared with the control condition (Web site, P = .03; brochure, P = .03). Only 46% of control patients reported an active decision-making role, compared with 56% of Web site and 54% of brochure patients. Patients exposed to a decision aid answered a greater percentage of knowledge questions correctly (54% control vs 69% Web site, P <.001, and vs 69% brochure, P <.001) and were less likely to be screened (94% control vs 86% Web site, P = .06, and vs 85% brochure, P = .04). CONCLUSIONS:Patients in the decision aid groups were more informed and more engaged in the screening decision than their control counterparts. Exposure did not promote shared decision-making control, however. Whether shared decision making is the ideal model and how to measure its occurrence are subjects for further research.
Authors: Dean J Wantland; Carmen J Portillo; William L Holzemer; Rob Slaughter; Eva M McGhee Journal: J Med Internet Res Date: 2004-11-10 Impact factor: 5.428
Authors: Barak Gaster; Kelly Edwards; Susan Brown Trinidad; Thomas H Gallagher; Clarence H Braddock Journal: Ann Intern Med Date: 2010-11-16 Impact factor: 25.391
Authors: France Légaré; Stéphane Turcotte; Dawn Stacey; Stéphane Ratté; Jennifer Kryworuchko; Ian D Graham Journal: Patient Date: 2012 Impact factor: 3.883
Authors: Meghan C Halley; Katharine A S Rendle; Katherine A Gillespie; Katherine M Stanley; Dominick L Frosch Journal: Health Expect Date: 2014-09-29 Impact factor: 3.377
Authors: Patrick M Archambault; Tom H van de Belt; Craig Kuziemsky; Ariane Plaisance; Audrey Dupuis; Carrie A McGinn; Rebecca Francois; Marie-Pierre Gagnon; Alexis F Turgeon; Tanya Horsley; William Witteman; Julien Poitras; Jean Lapointe; Kevin Brand; Jean Lachaine; France Légaré Journal: Cochrane Database Syst Rev Date: 2017-05-10
Authors: Caroline S Dorfman; Randi M Williams; Elisabeth C Kassan; Sara N Red; David L Dawson; William Tuong; Elizabeth R Parker; Janet Ohene-Frempong; Kimberly M Davis; Alexander H Krist; Steven H Woolf; Marc D Schwartz; Mary B Fishman; Carmella Cole; Kathryn L Taylor Journal: BMC Med Inform Decis Mak Date: 2010-03-03 Impact factor: 2.796
Authors: Rhodri Evans; Natalie Joseph-Williams; Adrian Edwards; Robert G Newcombe; Patricia Wright; Paul Kinnersley; Jeff Griffiths; Mari Jones; Janet Williams; Richard Grol; Glyn Elwyn Journal: J Med Internet Res Date: 2010-08-06 Impact factor: 5.428
Authors: Eleanor Mann; A Toby Prevost; Simon Griffin; Ian Kellar; Stephen Sutton; Michael Parker; Simon Sanderson; Ann Louise Kinmonth; Theresa M Marteau Journal: BMC Public Health Date: 2009-02-20 Impact factor: 3.295