Shared decision-making before prostate cancer screening decisions
(2024) In Nature Reviews Urology- Abstract
Decisions around prostate-specific antigen screening require a patient-centred approach, considering the benefits and risks of potential harm. Using shared decision-making (SDM) can improve men’s knowledge and reduce decisional conflict. SDM is supported by evidence, but can be difficult to implement in clinical settings. An inclusive definition of SDM was used in order to determine the prevalence of SDM in prostate cancer screening decisions. Despite consensus among guidelines endorsing SDM practice, the prevalence of SDM occurring before the decision to undergo or forgo prostate-specific antigen testing varied between 11% and 98%, and was higher in studies in which SDM was self-reported by physicians than in patient-reported... (More)
Decisions around prostate-specific antigen screening require a patient-centred approach, considering the benefits and risks of potential harm. Using shared decision-making (SDM) can improve men’s knowledge and reduce decisional conflict. SDM is supported by evidence, but can be difficult to implement in clinical settings. An inclusive definition of SDM was used in order to determine the prevalence of SDM in prostate cancer screening decisions. Despite consensus among guidelines endorsing SDM practice, the prevalence of SDM occurring before the decision to undergo or forgo prostate-specific antigen testing varied between 11% and 98%, and was higher in studies in which SDM was self-reported by physicians than in patient-reported recollections and observed practices. The influence of trust and continuity in physician–patient relationships were identified as facilitators of SDM, whereas common barriers included limited appointment times and poor health literacy. Decision aids, which can help physicians to convey health information within a limited time frame and give patients increased autonomy over decisions, are underused and were not shown to clearly influence whether SDM occurs. Future studies should focus on methods to facilitate the use of SDM in clinical settings.
(Less)
- author
- Pekala, Kelly R. ; Shill, Daniela K. ; Austria, Mia ; Langford, Aisha T. ; Loeb, Stacy and Carlsson, Sigrid V. LU
- organization
- publishing date
- 2024
- type
- Contribution to journal
- publication status
- epub
- subject
- in
- Nature Reviews Urology
- publisher
- Nature Publishing Group
- external identifiers
-
- pmid:38168921
- scopus:85181213648
- ISSN
- 1759-4812
- DOI
- 10.1038/s41585-023-00840-0
- language
- English
- LU publication?
- yes
- id
- 679544bd-870d-4fe7-b288-8b2203c8d263
- date added to LUP
- 2024-02-06 13:48:24
- date last changed
- 2024-04-23 16:03:15
@article{679544bd-870d-4fe7-b288-8b2203c8d263,
abstract = {{<p>Decisions around prostate-specific antigen screening require a patient-centred approach, considering the benefits and risks of potential harm. Using shared decision-making (SDM) can improve men’s knowledge and reduce decisional conflict. SDM is supported by evidence, but can be difficult to implement in clinical settings. An inclusive definition of SDM was used in order to determine the prevalence of SDM in prostate cancer screening decisions. Despite consensus among guidelines endorsing SDM practice, the prevalence of SDM occurring before the decision to undergo or forgo prostate-specific antigen testing varied between 11% and 98%, and was higher in studies in which SDM was self-reported by physicians than in patient-reported recollections and observed practices. The influence of trust and continuity in physician–patient relationships were identified as facilitators of SDM, whereas common barriers included limited appointment times and poor health literacy. Decision aids, which can help physicians to convey health information within a limited time frame and give patients increased autonomy over decisions, are underused and were not shown to clearly influence whether SDM occurs. Future studies should focus on methods to facilitate the use of SDM in clinical settings.</p>}},
author = {{Pekala, Kelly R. and Shill, Daniela K. and Austria, Mia and Langford, Aisha T. and Loeb, Stacy and Carlsson, Sigrid V.}},
issn = {{1759-4812}},
language = {{eng}},
publisher = {{Nature Publishing Group}},
series = {{Nature Reviews Urology}},
title = {{Shared decision-making before prostate cancer screening decisions}},
url = {{http://dx.doi.org/10.1038/s41585-023-00840-0}},
doi = {{10.1038/s41585-023-00840-0}},
year = {{2024}},
}