Shared Decision Making in Prostate-Specific Antigen Testing
Introduction and aims: Professional societies recommend that the decision to screen for prostate cancer involves a shared discussion between patient and provider. Many men are tested without this discussion. Prostate cancer screening decision aids increase patient knowledge and participation in pros...
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| Main Authors: | , , , , |
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| Format: | Book |
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SAGE Publishing,
2013-01-01T00:00:00Z.
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| Online Access: | Connect to this object online. |
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| Summary: | Introduction and aims: Professional societies recommend that the decision to screen for prostate cancer involves a shared discussion between patient and provider. Many men are tested without this discussion. Prostate cancer screening decision aids increase patient knowledge and participation in prostate-specific antigen (PSA) testing decisions under ideal circumstances but are often resource intensive and elaborate. There is a need for evaluation of interventions that are low cost, low literacy, and practical for widespread distribution. The authors evaluated the effect of a mailed low-literacy informational patient flyer about the PSA test on measures of shared decision making. Methods: A pragmatic randomized controlled trial comparing the mailed flyer versus usual care was conducted among 303 men aged 50 to 74 years who were scheduled for annual health maintenance exams in 2 general internal medicine clinics (University of Colorado and University of Colorado Hospital). Charts were reviewed after the visits for documentation of PSA screening discussions and PSA testing rates. Follow-up patient surveys assessed include perceived participation in PSA screening decisions, knowledge of the PSA test, and flyer acceptability. Results: Rates of chart-documented PSA discussions were low with no difference between the flyer and control groups (17.7% and 13.6%, respectively; P = .28). Rates of PSA testing were also similar in both groups (62.5% vs 58.5%; P = .48). Rates of patient-reported PSA discussions were higher than the documented rates but also without differences between the groups (71.8% vs 62.3%; P = .22). The intervention had no effect in the PSA knowledge scores (3.5/5 vs 3.3/5, P = .60). Patients found the flyer to be highly acceptable. Conclusions: A mailed low-literacy informational flyer was well received by patients but had no effect on rates of PSA discussions, PSA testing, or patient knowledge of prostate cancer screening. |
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| Item Description: | 2150-1319 2150-1327 10.1177/2150131912447074 |