Decision Support with the Personal Patient Profile-Prostate: A Multicenter Randomized Trial

Area of Science:

• Urology
• Health Informatics
• Decision Science

Background:

• Localized prostate cancer presents complex treatment decisions for patients.
• Shared decision-making is crucial for patient-centered prostate cancer care.
• Existing decision aids require evaluation for efficacy in diverse patient populations.

Purpose of the Study:

• To evaluate the efficacy of the web-based Personal Patient Profile-Prostate (P3P) decision aid.
• To compare decisional conflict in men with localized prostate cancer using P3P versus usual care.
• To identify factors influencing decisional conflict in this patient group.

Main Methods:

• A randomized controlled trial with 392 men with localized prostate cancer.
• Intervention group received P3P decision aid; control group received usual care.
• Decisional conflict was measured at 1 month using validated scales.

Main Results:

• The P3P decision aid group showed significantly reduced decisional conflict (-5.00, 95% CI -9.40--0.59).
• Mean decisional conflict scores were 10.9 ± 16.7 for intervention and 9.9 ± 18.0 for usual care.
• Predictors of conflict included income, marital status, decision status, consultations, site, and risk classification.

Conclusions:

• The P3P decision aid is an effective adjunct for shared decision-making in localized prostate cancer.
• Risk classification, consultations, and resources significantly impacted decisional conflict.
• Web-based decision aids can improve patient engagement and reduce conflict in cancer care.