Mp24-05 Narrative Content of Patients During Multidisciplinary Consultations for Clinically Localized Prostate Cancer

You have accessJournal of UrologyHealth Services Research: Practice Patterns, Quality of Life and Shared Decision Making II (MP24)1 May 2024MP24-05 NARRATIVE CONTENT OF PATIENTS DURING MULTIDISCIPLINARY CONSULTATIONS FOR CLINICALLY LOCALIZED PROSTATE CANCER Paul Kokorowski, Nadine Friedrich, Michael Luu, Alexander Shiang, Sanjay Das, James Daniels, Stephen Freedland, Brennan Spiegel, and Timothy Daskivich Paul KokorowskiPaul Kokorowski , Nadine FriedrichNadine Friedrich , Michael LuuMichael Luu , Alexander ShiangAlexander Shiang , Sanjay DasSanjay Das , James DanielsJames Daniels , Stephen FreedlandStephen Freedland , Brennan SpiegelBrennan Spiegel , and Timothy DaskivichTimothy Daskivich View All Author Informationhttps://doi.org/10.1097/01.JU.0001008860.46052.c4.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Effective shared decision making (SDM) depends on contributions of both patients and providers to determine which treatment best matches the patient's values and preferences. While the optimal content for providers to address in SDM has been thoroughly studied, the role of the patient is less well characterized. We sought to describe time spent speaking, types of speech, and content discussed by patients in consultations for localized prostate cancer. METHODS: We transcribed 50 consultations of men with localized prostate cancer across a multidisciplinary sample of 4 urologists, 2 radiation oncologists, and 4 medical oncologists. All patient statements were extracted, as defined by conversation turns. The number of patient words per consult and proportion of total words per consult were calculated as a proxy for time spent. Statements were coded for type of speech and specific content using an open coding approach. Specific content was then categorized into thematic content areas. Saliency analysis was used to describe frequency of content, with total number of patient statements as the denominator. RESULTS: Our analytic sample included 6,601 patient statements from 28 Urology, 11 Radiation Oncology, 11 Medical Oncology consultations. Patient statements comprised a median of 19.9% (IQR 12.7%, 32.3%) of total words per consultation, with a broad range (1.8% to 51.1%). Coders identified 5 primary types of speech: acknowledgements (17%), expressions/preferences (15%), questions/requests (25%), providing information (31%) and other (12%). The most time was spent non-specific acknowledgements/non-contributory speech (28%) and sharing medical/family history (20%). There were a median of 21.5 (IQR 10, 43.5) patient questions/requests per consultation, with a broad range (3 to 175). Of the 1,693 question/requests identified, the most common thematic content areas related to treatment details/logistics (29%), the decision making process (11%), cancer risk/prognosis (10%), and treatment side effects (8.8%). Of the 1,009 expressions/preferences identified, most were simple emotive (69%), treatment preferences (10%), treatment related values (9.2%), and preferences related to decision-making process (8.6%). CONCLUSIONS: Patient participation in prostate cancer consultations was variable, as measured by proportion of time spent speaking and number of questions asked. Only 15% of time is spent expressing preferences and values. Providers should seek to ensure adequate participation of patients in SDM, prioritizing elicitation of values and preferences. Source of Funding: This work was supported by Career Development Award (K08 CA230155 to TJD) from the National Cancer Institute. Dr. Friedrich was funded by NIH grant T32 CA240172-03 © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e393 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Paul Kokorowski More articles by this author Nadine Friedrich More articles by this author Michael Luu More articles by this author Alexander Shiang More articles by this author Sanjay Das More articles by this author James Daniels More articles by this author Stephen Freedland More articles by this author Brennan Spiegel More articles by this author Timothy Daskivich More articles by this author Expand All Advertisement PDF downloadLoading ...