Effects of Decision Support Interventions on Treatment Decision‐Making in Patients With Prostate Cancer: A Systematic Review and Network Meta‐Analysis

PURPOSE: To compare the effectiveness of decision support interventions on treatment decision-making outcomes among men with prostate cancer. METHODS: A systematic review of randomized controlled trials was conducted. Electronic databases were searched from inception to March 2026. Eligible studies evaluated decision support interventions delivered during the prostate cancer treatment decision-making phase, including booklet-based, digital, and multimodal formats. The primary outcome was decision conflict. Secondary outcomes included decision regret, knowledge, decision readiness, and psychological distress. Bayesian network meta-analysis and conventional pairwise meta-analysis were used to compare intervention effects. RESULTS: Thirteen randomized controlled trials were included. Decision support interventions were categorized into three types: booklet-based, digital, and multimodal interventions. Network meta-analysis showed that booklet-based interventions reduced decision conflict (SMD = -0.98, 95% CI -1.60 to -0.24). No statistically significant effects were observed for decision regret or knowledge level. Pairwise meta-analysis showed that decision support interventions improved decision readiness but had limited effects on psychological distress. CONCLUSIONS: Decision support interventions showed outcome-specific effects in patients with prostate cancer facing treatment decisions, with booklet-based interventions providing the clearest signal for reducing decision conflict and overall interventions improving decision readiness. These findings support further evaluation of accessible, low-burden, and age-friendly decision support formats in prostate cancer treatment decision-making.