Physicians' Perceptions of Factors Influencing the Treatment Decision-making Process for Men With Low-risk Prostate Cancer

Kimberly Davis; Paula Bellini; Charlotte Hagerman; Riley Zinar; Daniel Leigh; Richard Hoffman; David Aaronson; Stephen Van Den Eeden; George Philips; Kathryn Taylor

doi:10.1016/j.urology.2017.02.056

Back

Physicians' Perceptions of Factors Influencing the Treatment Decision-making Process for Men With Low-risk Prostate Cancer

Journal article

Open access

Peer reviewed

Physicians' Perceptions of Factors Influencing the Treatment Decision-making Process for Men With Low-risk Prostate Cancer

Kimberly Davis, Paula Bellini, Charlotte Hagerman, Riley Zinar, Daniel Leigh, Richard Hoffman, David Aaronson, Stephen Van Den Eeden, George Philips and Kathryn Taylor

Urology (Ridgewood, N.J.), Vol.107, pp.86-95

09/2017

DOI: 10.1016/j.urology.2017.02.056

PMCID: PMC5880528

PMID: 28454988

Files and links (1)

url

https://doi.org/10.1016/j.urology.2017.02.056View

Published (Version of record) Open Access

Abstract

To assess physicians' attitudes regarding multiple factors that may influence recommendations for active surveillance (AS) vs active treatment (AT) given the central role physicians play in the treatment decision-making process. We conducted semistructured interviews to assess factors that physicians consider important when recommending AS vs AT, as well as physicians' perceptions of what their patients consider important in the decision. Participants included urologists (N = 11), radiation oncologists (N = 12), and primary care physicians (N = 10) from both integrated and fee-for-service healthcare settings. Across the specialties, quantitative data indicated that most physicians reported that their recommendations for AS were influenced by patients' older age, willingness and ability to follow a surveillance protocol, anxiety, comorbidities, life expectancy, and treatment preferences. Qualitative findings highlighted physicians' concerns about malpractice lawsuits, given the possibility of disease progression. Additionally, most physicians noted the role of the healthcare setting, suggesting that financial incentives may be associated with AT recommendations in fee-for-service settings. Finally, most physicians reported spouse or family opposition to AS due to their own anxiety or lack of understanding of AS. We found that patient and physician preferences, healthcare setting, and family or spouse factors influence physicians' treatment recommendations for men with low-risk PCa. These were consistent themes across physician subspecialties in both an Health Maintenance Organization and in fee-for-service settings.

Decision Making

Attitude of Health Personnel

Practice Patterns, Physicians' - standards

United States

Humans

Middle Aged

Male

Combined Modality Therapy

Prostatic Neoplasms - therapy

Physicians - standards

Adult

Perception

Surveys and Questionnaires

Physicians - psychology

Physician's Role

Details

Title: Subtitle: Physicians' Perceptions of Factors Influencing the Treatment Decision-making Process for Men With Low-risk Prostate Cancer
Creators: Kimberly Davis - Department of Oncology, Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, DC. Electronic address: kmd54@georgetown.edu
Paula Bellini - Department of Oncology, Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, DC
Charlotte Hagerman - Department of Oncology, Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, DC
Riley Zinar - Department of Oncology, Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, DC
Daniel Leigh - Department of Oncology, Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, DC
Richard Hoffman - Division of General Internal Medicine, University of Iowa Carver College of Medicine/Iowa City VA Medical Center, Iowa City, IA
David Aaronson - Department of Urology, Kaiser Permanente, East Bay, Oakland, CA
Stephen Van Den Eeden - Division of Research, Kaiser Permanente Northern California, Oakland, CA
George Philips - Department of Medicine, MedStar Georgetown University Hospital Center, Washington, DC
Kathryn Taylor - Department of Oncology, Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, DC
Resource Type: Journal article
Publication Details: Urology (Ridgewood, N.J.), Vol.107, pp.86-95
DOI: 10.1016/j.urology.2017.02.056
PMID: 28454988
PMCID: PMC5880528
NLM abbreviation: Urology
ISSN: 0090-4295
eISSN: 1527-9995
Grant note: P30 CA086862 / NCI NIH HHS R01 CA155578 / NCI NIH HHS
Language: English
Date published: 09/2017
Academic Unit: Epidemiology; General Internal Medicine; Internal Medicine
Record Identifier: 9984094361402771

Metrics

29 Record Views

9 Times Cited - Web of Science