Online decision aid for patients with prostate cancer evaluated by 11 290 patients and 91 urologists in Germany

BJU Int. 2024 Aug;134(2):239-248. doi: 10.1111/bju.16329. Epub 2024 Mar 20.

Abstract

Objective: To evaluate the nationwide online decision aid 'Entscheidungshilfe Prostatakrebs' (established in 2016, >11.000 users and 60 new users/week) for patients with non-metastatic prostate cancer (PCa), from the perspective of patients and urologists.

Patients and methods: To provide personalised information, the tool collects most of the International Consortium for Health Outcomes Measurement standard set, personal preferences, psychological features, and a validated rating of the tool. To evaluate urologists' opinions, we developed a structured two-page questionnaire. All data were collected anonymously.

Results: From June 2016 to December 2020, 11 290 patients used the PCa decision aid. Their median (interquartile range [IQR]) age was 67 (61-72) years. The median (IQR) time from initial diagnosis to using the tool was 4 (3-7) weeks. In all, 87.7% of users reported high satisfaction. In a multivariable model, predictors for considering observation were higher knowledge, using the decision aid alone, lower oncological risk, normal erectile function, and respective personal preferences. Of 194 urologists, 91 (47%) had implemented the decision aid in their clinical practice. The urologists' mean (SD) satisfaction score (1 'very good'; 6 'unsatisfactory') with it was 1.45 (0.55), and 92% recommended it. Half of the urologists reported time savings.

Conclusion: Patients and urologists report a very high level of acceptance and satisfaction with this online tool. It offers advantages in shared decision-making and time efficiency. The usage of the decision aid might improve the adoption of active surveillance and watchful waiting when indicated.

Keywords: decision aid; decision making; health services research; prostate cancer; shared decision‐making.

MeSH terms

  • Aged
  • Decision Support Techniques*
  • Germany
  • Humans
  • Internet
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Prostatic Neoplasms* / psychology
  • Prostatic Neoplasms* / therapy
  • Surveys and Questionnaires
  • Urologists* / statistics & numerical data