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Impact of a Prostate Specific Antigen Screening Decision Aid on Clinic Function.

ABSTRACT: INTRODUCTION:Decision aids (DAs) around prostate cancer screening can increase knowledge and shared decision making (SDM), but remain underutilized due to cost and time constraints that disrupt clinic flow. We examined the impact of a simple prostate specific antigen (PSA) screening DA distribution strategy on clinic flow as well as SDM in a diverse urban primary care clinic. METHODS:Men ages 50-75 viewed the DA while waiting for physicians. Participants and physicians completed questionnaires evaluating the SDM process. Focus groups were conducted with clinic staff and physicians to evaluate the impact on clinic operations. RESULTS:Fifty percent of men discussed PSA screening and 85% reported the DA made decision making easier. Participants reported an average of 12.9 min reading the DA. Participants reported high decision satisfaction and low decisional conflict. Physicians reported an average of 5.2 minutes discussing PSA screening. Clinic staff reported increased enthusiasm for the process after adjustments were made in response to concerns including time, and lack of both knowledge about the DA subject matter and involvement in the process. Physician-reported barriers included ambivalence about PSA screening. CONCLUSIONS:A PSA DA, requiring few resources, can be implemented with broad involvement of clinic staff and minimal disruption to clinic flow in an urban primary care clinic, and may facilitate SDM.

SUBMITTER: Warlick CA

PROVIDER: S-EPMC6552677 | biostudies-literature | 2017 Nov

REPOSITORIES: biostudies-literature

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Impact of a Prostate Specific Antigen Screening Decision Aid on Clinic Function.

Warlick Christopher A CA Berge Jerica M JM Ho Yen-Yi YY Yeazel Mark M

Urology practice 20171101 6

<h4>Introduction</h4>Decision aids (DAs) around prostate cancer screening can increase knowledge and shared decision making (SDM), but remain underutilized due to cost and time constraints that disrupt clinic flow. We examined the impact of a simple prostate specific antigen (PSA) screening DA distribution strategy on clinic flow as well as SDM in a diverse urban primary care clinic.<h4>Methods</h4>Men ages 50-75 viewed the DA while waiting for physicians. Participants and physicians completed q ...[more]

PMID: 31179375

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Project description:BackgroundWhether early detection and treatment of prostate cancer (PCa) will reduce disease-related mortality remains uncertain. As a result, tools are needed to facilitate informed decision making. While there have been several decision aids (DAs) developed and tested, very few have included an exercise to help men clarify their values and preferences about PCa screening. Further, only one DA has utilized an interactive web-based format, which allows for an expansion and customization of the material. We describe the development of two DAs, a booklet and an interactive website, each with a values clarification component and designed for use in diverse settings.MethodsWe conducted two feasibility studies to assess men's (45-70 years) Internet access and their willingness to use a web- vs. a print-based tool. The booklet was adapted from two previous versions evaluated in randomized controlled trials (RCTs) and the website was created to closely match the content of the revised booklet. Usability testing was conducted to obtain feedback regarding draft versions of the materials. The tools were also reviewed by a plain language expert and the interdisciplinary research team. Feedback on the content and presentation led to iterative modifications of the tools.ResultsThe feasibility studies confirmed that the Internet was a viable medium, as the majority of men used a computer, had access to the Internet, and Internet use increased over time. Feedback from the usability testing on the length, presentation, and content of the materials was incorporated into the final versions of the booklet and website. Both the feasibility studies and the usability testing highlighted the need to address men's informed decision making regarding screening.ConclusionsInformed decision making for PCa screening is crucial at present and may be important for some time, particularly if a definitive recommendation either for or against screening does not emerge from ongoing prostate cancer screening trials. We have detailed our efforts at developing print- and web-based DAs to assist men in determining how to best meet their PCa screening preferences. Following completion of our ongoing RCT designed to test these materials, our goal will be to develop a dissemination project for the more effective tool.Trial registrationNCT00623090.

Dataset Information

Impact of a Prostate Specific Antigen Screening Decision Aid on Clinic Function.

Publications

Impact of a Prostate Specific Antigen Screening Decision Aid on Clinic Function.

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