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Evaluating Clinical Implementation Approaches for Prostate Cancer Decision Support.

Donna L Berry1, Fangxin Hong1, Barbara Halpenny1

  • 1Dana-Farber Cancer Institute, Boston, Massachusetts.

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Summary

Implementing shared decision-making tools for prostate cancer requires engaging physicians and dedicated staff follow-up. Multimodal strategies are key for successful integration into clinical practice.

Keywords:
decision support techniquesevidence-based practicemedical informaticsprostatic neoplasms

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Area of Science:

  • Health Services Research
  • Implementation Science
  • Oncology Decision Support

Background:

  • Shared decision-making (SDM) is crucial for localized prostate cancer counseling.
  • Decision aids show efficacy in trials but lack widespread clinical implementation.
  • This study assessed implementation strategies for the P3P (Personal Patient Profile-Prostate) decision aid.

Purpose of the Study:

  • Evaluate implementation strategies for the P3P decision aid in urology clinics.
  • Analyze clinical staff and provider feedback on implementation barriers and facilitators.
  • Identify factors promoting successful adoption of decision support tools.

Main Methods:

  • Hybrid type 1 effectiveness-implementation trial across 6 urology clinics.
  • Co-designed site-specific implementation strategies with clinic leaders.
  • Monitored referral/access metrics and conducted staff focus groups for qualitative feedback.

Main Results:

  • 51% of eligible men were informed about the P3P tool; 43% accessed it.
  • Highest access rates achieved via patient care coordinator outreach and physician-led invitations.
  • Physicians found summaries useful; staff cited workflow and resource barriers. Clinical lead and physician engagement were key facilitators.

Conclusions:

  • Successful implementation hinges on physician engagement and proactive staff follow-up.
  • Multimodal strategies are essential for early success in adopting new clinical interventions.
  • Optimizing decision aid implementation requires addressing workflow and resource challenges.