Effects of a Patient Decision Aid for Nonmetastatic Prostate Cancer Established in Routine Care: The Randomized Controlled EvEnt-PCA Trial.

IF 5.6 2区医学 Q1 UROLOGY & NEPHROLOGY

European urology focus Pub Date : 2025-09-08 DOI:10.1016/j.euf.2025.07.019

Johannes Huber, Philipp Karschuck, Rainer Koch, Andreas Ihrig, Tanja Krones, Andreas Neisius, Sven von Ahn, Christian Klopf, Steffen Weikert, Michael Siebels, Nicolas Haseke, Christian Weißflog, Martin Baunacke, Peter Liske, Georgi Tosev, Thomas Benusch, Martin Schostak, Joachim Stein, Philipp Spiegelhalder, Christian Thomas, Cem Aksoy, Luka Flegar, Christer Groeben

{"title":"Effects of a Patient Decision Aid for Nonmetastatic Prostate Cancer Established in Routine Care: The Randomized Controlled EvEnt-PCA Trial.","authors":"Johannes Huber, Philipp Karschuck, Rainer Koch, Andreas Ihrig, Tanja Krones, Andreas Neisius, Sven von Ahn, Christian Klopf, Steffen Weikert, Michael Siebels, Nicolas Haseke, Christian Weißflog, Martin Baunacke, Peter Liske, Georgi Tosev, Thomas Benusch, Martin Schostak, Joachim Stein, Philipp Spiegelhalder, Christian Thomas, Cem Aksoy, Luka Flegar, Christer Groeben","doi":"10.1016/j.euf.2025.07.019","DOIUrl":null,"url":null,"abstract":"Background and objective: Since 2016, >21 000 patients with prostate cancer (PC) used our personalized online decision aid in routine care in Germany. We analyzed the effects of this online decision aid for men with nonmetastatic PC in a randomized controlled trial.Methods: In the randomized controlled EvEnt-PCA trial, 116 centers performed 1:1 allocation of 1115 patients with nonmetastatic PC to use an online decision aid (intervention = I) or a printed brochure (control = C). The primary outcome was treatment decision after 14 mo. The secondary endpoints were knowledge, acceptance, decisional conflict, physician-patient communication, anxiety and depression, decision regret, and quality of life.Key findings and limitations: With complete data from 1000 patients, there was no difference between the two groups in terms of primary or secondary endpoints. In the intervention group, consultation time was shorter (I: 61 min vs C: 70 min, p = 0.02), and more patients provided a summary of their preparation (I: 76% vs C: 56%, p < 0.001). Life expectancy (I: 53% vs C: 47%, p = 0.03), radiotherapy (I: 90% vs C: 84%, p = 0.005), rehabilitation (I: 69% vs C: 62%, p = 0.02), and psycho-oncology (I: 21% vs C: 16%, p = 0.07) were discussed more frequently in the intervention group. Additionally, more counseling sessions with general practitioners (I: 43% vs C: 35%, p = 0.01) and radiotherapists (I: 24% vs C: 18%, p = 0.03) were held in the intervention group.Conclusions and clinical implications: The use of the online decision aid was associated with structural improvements, for example, significantly shorter doctor-patient consultation time. Our findings suggest stronger guideline adherence in the counseling process and promotion of health literacy. Successful implementation of our online decision aid in routine care can provide an example for solving this key obstacle for shared decision-making.","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":5.6000,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European urology focus","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.euf.2025.07.019","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background and objective: Since 2016, >21 000 patients with prostate cancer (PC) used our personalized online decision aid in routine care in Germany. We analyzed the effects of this online decision aid for men with nonmetastatic PC in a randomized controlled trial.

Methods: In the randomized controlled EvEnt-PCA trial, 116 centers performed 1:1 allocation of 1115 patients with nonmetastatic PC to use an online decision aid (intervention = I) or a printed brochure (control = C). The primary outcome was treatment decision after 14 mo. The secondary endpoints were knowledge, acceptance, decisional conflict, physician-patient communication, anxiety and depression, decision regret, and quality of life.

Key findings and limitations: With complete data from 1000 patients, there was no difference between the two groups in terms of primary or secondary endpoints. In the intervention group, consultation time was shorter (I: 61 min vs C: 70 min, p = 0.02), and more patients provided a summary of their preparation (I: 76% vs C: 56%, p < 0.001). Life expectancy (I: 53% vs C: 47%, p = 0.03), radiotherapy (I: 90% vs C: 84%, p = 0.005), rehabilitation (I: 69% vs C: 62%, p = 0.02), and psycho-oncology (I: 21% vs C: 16%, p = 0.07) were discussed more frequently in the intervention group. Additionally, more counseling sessions with general practitioners (I: 43% vs C: 35%, p = 0.01) and radiotherapists (I: 24% vs C: 18%, p = 0.03) were held in the intervention group.

Conclusions and clinical implications: The use of the online decision aid was associated with structural improvements, for example, significantly shorter doctor-patient consultation time. Our findings suggest stronger guideline adherence in the counseling process and promotion of health literacy. Successful implementation of our online decision aid in routine care can provide an example for solving this key obstacle for shared decision-making.

查看原文本刊更多论文

在常规护理中建立的非转移性前列腺癌患者决策辅助的效果：随机对照事件- pca试验。

背景与目的：自2016年以来，德国有bb1021000名前列腺癌（PC）患者在常规护理中使用了我们的个性化在线决策辅助。我们在一项随机对照试验中分析了这种在线决策辅助对非转移性PC患者的影响。方法：在随机对照EvEnt-PCA试验中，116个中心对1115例非转移性PC患者进行1:1分配，使用在线决策辅助（干预= I）或印刷手册（对照= C）。主要终点是14个月后的治疗决定。次要终点是知识、接受度、决定冲突、医患沟通、焦虑和抑郁、决定后悔和生活质量。主要发现和局限性：在1000例患者的完整数据中，两组在主要或次要终点方面没有差异。在干预组，咨询时间更短（I: 61分钟vs C: 70分钟，p = 0.02），更多的患者提供了他们的准备总结(I: 76% vs C: 56%， p结论和临床意义：使用在线决策辅助与结构改善有关，例如，显着缩短医患咨询时间。我们的研究结果表明，在咨询过程中更强的指南依从性和促进健康素养。我们在日常护理中成功实施的在线决策辅助可以为解决共同决策的这一关键障碍提供一个例子。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

European urology focus Medicine-Urology

CiteScore

10.40

自引率

3.70%

发文量

274

审稿时长

23 days

期刊介绍： European Urology Focus is a new sister journal to European Urology and an official publication of the European Association of Urology (EAU). EU Focus will publish original articles, opinion piece editorials and topical reviews on a wide range of urological issues such as oncology, functional urology, reconstructive urology, laparoscopy, robotic surgery, endourology, female urology, andrology, paediatric urology and sexual medicine. The editorial team welcome basic and translational research articles in the field of urological diseases. Authors may be solicited by the Editor directly. All submitted manuscripts will be peer-reviewed by a panel of experts before being considered for publication.