Characterizing the impact of novel patient-centered pathology reports on men undergoing prostate biopsy: The PAPR randomized controlled trial.

Abstract

INTRODUCTION AND OBJECTIVES To improve patient-centered communication, some institutions provide online portals for patients to immediately access medical results. However, early access to certain reports could harm patients. Standard pathology reports (SPRs), vital for clinical decision making, can be difficult for patients to understand and contextualize. Our group designed patient-centered pathology reports (PAPR) and tested them for patients undergoing prostate biopsy. METHODS Between February 2023 to January 2024, 121 men were randomly assigned to receive either SPR or SPR + PAPR. Prior to follow-up encounters, participants completed a questionnaire examining their understanding of the reports and experience interacting with them and a validated anxiety questionnaire (STAIS-5). Following the visit, patients completed a validated shared decision-making questionnaire (SDM-Q-9). RESULTS Twenty-four patients were excluded with unanswered questionnaires leaving 97 patients with evaluable data. There was no difference in shared decision making between arms. Patients receiving SPR+PAPR agreed that their reports were patient friendly (74% vs. 20%, p<0.001), easy to understand (71% vs. 32%, p<0.001), improved experience (83% vs. 60%, p=0.029), empowered control (65% vs. 30%, p=0.001), reduced anxiety (81% vs. 31%, p<0.001), and helped communicating results to others (77% vs. 42%, p<0.001). The SPR+PAPR group more accurately understood their results (median 4 vs. 3 correct answers; p=0.003) and treatment options (63% vs. 13%, p<0.001). Anxiety increased less in the SPR+PAPR arm. CONCLUSIONS When comparing patient-centered to standard pathology reports, we did not see evidence of an impact on shared decision-making, but there were statistically significant differences in patient understanding and experience. Generalizability is limited by high resources needed to create PAPRs.