Effects of a Patient Decision Aid for Nonmetastatic Prostate Cancer Established in Routine Care: The Randomized...

Area of Science:

• Oncology
• Health Informatics
• Patient Decision Aids

Background:

• Over 21,000 prostate cancer (PC) patients in Germany have used a personalized online decision aid since 2016.
• A randomized controlled trial analyzed the impact of this digital tool on men with nonmetastatic PC.

Purpose of the Study:

• To evaluate the effects of an online decision aid compared to a printed brochure in routine care for nonmetastatic prostate cancer patients.
• To assess impacts on treatment decisions, patient knowledge, communication, and quality of life.

Main Methods:

• The EvEnt-PCA trial randomized 1115 nonmetastatic PC patients across 116 centers.
• Patients were allocated 1:1 to use an online decision aid (intervention) or a printed brochure (control).
• Primary outcome was treatment decision at 14 months; secondary outcomes included knowledge, acceptance, decisional conflict, communication, anxiety, depression, regret, and quality of life.

Main Results:

• No significant differences were observed in primary or secondary endpoints between the intervention and control groups among 1000 patients with complete data.
• The intervention group experienced shorter consultation times (61 vs. 70 minutes) and increased patient preparation summaries (76% vs. 56%).
• Discussions on life expectancy, radiotherapy, rehabilitation, and psycho-oncology were more frequent in the intervention group, alongside increased counseling sessions with general practitioners and radiotherapists.

Conclusions:

• The online decision aid demonstrated structural improvements, notably reducing doctor-patient consultation time.
• Findings suggest enhanced guideline adherence and improved health literacy in the counseling process.
• Successful implementation of this online decision aid can serve as a model for overcoming obstacles in shared decision-making.