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Accepted (AM)Open Access (License Unspecified), Open
Journal article
Physicians' Perceptions of Factors Influencing the Treatment Decision-making Process for Men With Low-risk Prostate Cancer
Urology (Ridgewood, N.J.), v 107, pp 86-95
01 Sep 2017
PMID: 28454988
Featured in Collection : UN Sustainable Development Goals @ Drexel
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.
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Details
- Title
- Physicians' Perceptions of Factors Influencing the Treatment Decision-making Process for Men With Low-risk Prostate Cancer
- Creators
- Kimberly Davis - Georgetown University Medical CenterPaula Bellini - Georgetown University Medical CenterCharlotte Hagerman - Drexel University, WELL CenterRiley Zinar - Georgetown University Medical CenterDaniel Leigh - Georgetown University Medical CenterRichard Hoffman - University of IowaDavid Aaronson - Kaiser PermanenteStephen Van Den Eeden - Kaiser PermanenteGeorge Philips - MedStar Georgetown University HospitalKathryn Taylor - Georgetown University Medical Center
- Publication Details
- Urology (Ridgewood, N.J.), v 107, pp 86-95
- Publisher
- Elsevier
- Grant note
- P30 CA086862 / NCI NIH HHS R01 CA155578 / NCI NIH HHS
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- WELL Center
- Web of Science ID
- WOS:000415138400022
- Scopus ID
- 2-s2.0-85026552967
- Other Identifier
- 991021903708604721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Urology & Nephrology