Open Access Open Access  Restricted Access Subscription or Fee Access

Oncology providers’ evaluation of the use of a prostate cancer treatment decision aid versus usual information provision: Results from the PCPCC trial

Maarten Cuypers, Romy E D Lamers, Paul J M Kil, Lonneke V van de Poll-Franse, Marieke de Vries


Objective: To compare care providers’ evaluations of an online prostate cancer treatment decision aid (DA) to an evaluation of usual information routines.

Methods: Oncology care providers (urologists and nurses, n=108) enrolled in the intervention (DA) or control (standard information) arm of a cluster randomized controlled trial were invited to fill out an online questionnaire to evaluate working with the DA or to evaluate usual information provision. Response rate was 58% (n=63). 

Results: The DA was provided to 368 patients and distributing care providers were supportive of the DA content and usability. Satisfaction (1-10) with the DA or standard information was comparable (M=7.8 vs M=8.1, p=0.14), although in the control arm, care providers perceived that patients already receive too much information. Time barriers were not expected or perceived. All care providers involved felt suitable to distribute DAs. Care providers with DA experience were more supportive of including DAs in clinical guidelines.

Conclusion: Care providers were satisfied with the DA and reported no time barriers. However, many care providers are already satisfied with standard information materials and fear overloading patients with information.


Barriers, clinical communication, decisional conflict, enablers, health innovation, health literacy, healthcare providers’ evaluations, implementation, information provision, patient decision aids, patient satisfaction, person-centered healthcare, prostat

Full Text:



O’Connor, A., Graham, I. & Visser, A. (2005). Implementing shared decision making in diverse health care systems: the role of patient decision aids. Patient Education and Counseling 57 (3) 247-249.

Barry, M.J. & Edgman-Levitan, S. (2012). Shared Decision Making - The Pinnacle of Patient-Centered Care. New England Journal of Medicine 366 (9) 780-781.

Stiggelbout, A.M., Van der Weijden, T., Wit, M.P.T.D., Frosch, D., Légaré, F., Montori, V.M., trevena, L. & Elwyn, G. (2012). Shared decision making: really putting patients at the centre of healthcare. British Medical Journal 344, e256.

Oshima Lee, E. & Emanuel, E.J. (2013). Shared Decision Making to Improve Care and Reduce Costs. New England Journal of Medicine 368 (1) 6-8.

O'Connor, A.M., Stacey, D., Barry, M.J., Col, N.F., Eden, K.B., Entwistle, V., Fiset, V., Holmes-Rovner, M., Khangura, S., Llwellyn-Thomas, H. & Rovner, D.R. (2007). Do Patient Decision Aids Meet Effectiveness Criteria of the International Patient Decision Aid Standards Collaboration? A Systematic Review and Meta-analysis. Medical Decision Making 27 (5) 554-574.

Stacey, D., Légaré, F., Col, N.F., Bennett, C.L., Barry, M.J., Eden, K.B., Holmes-Rovner, M., Llwellyn-Thomas, H., Lyddiatt, A., Thomson, R. & Trevena, L. (2017). Decision aids for people facing health treatment or screening decisions. Cochrane Database of Systematic Reviews 4: CD001431.

Knops, A.M., Legemate, D.A., Goossens, A., Bossuyt, P.M.M. & Ubbink, D.T. (2013). Decision Aids for Patients Facing a Surgical Treatment Decision: A Systematic Review and Meta-analysis. Annals of Surgery 257 (5) 860-866.

Elwyn, G., Scholl, I., Tietbohl, C., Mann, M., Edwards, A.G., Clay, C., Légaré, F., van der Weijden, T., Lewis, C.L., Wexler, R.M. & Frosch, D.L. (2013). “Many miles to go …”: a systematic review of the implementation of patient decision support interventions into routine clinical practice. BMC Medical Informatics and Decision Making 13 (2) 1-10.

Pollard, S., Bansback, N. & Bryan, S. (2015). Physician attitudes toward shared decision making: A systematic review. Patient Education and Counseling 98 (9) 1046-1057.

Politi, M.C., Adsul, P., Kuzemchak, M.D., Zeuner, R. & Frosch, D.L. (2015). Clinicians' perceptions of digital vs. paper-based decision support interventions. Journal of Evaluation in Clinical Practice 21 (2) 175-179.

Légaré, F., Ratté, S., Gravel, K. & Graham, I.D. (2008). Barriers and facilitators to implementing shared decision-making in clinical practice: Update of a systematic review of health professionals’ perceptions. Patient Education and Counseling 73 (3) 526-535.

Orom, H., Penner, L.A., West, B.T., Downs, T.M., Rayford, W. & Underwood, W. (2009). Personality predicts prostate cancer treatment decision-making difficulty and satisfaction. Psycho-Oncology 18 (3) 290-299.

Holmes-Rovner, M., Montgomery, J.S., Rovner, D.R., Scherer, L.D., Whitfield, J., Kahn, V.C., Merkle, E.C., Ubel, P.A. & Fagerlin, A. (2015). Informed Decision Making: Assessment of the Quality of Physician Communication about Prostate Cancer Diagnosis and Treatment. Medical Decision Making 35 (8) 999-1009.

Ferlay, J., Soerjomataram, I., Dikshit, R., Eser, S., Mathers, C., Rebelo, M., Parkin, D.M., Forman, D. & Bray, F. (2015). Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. International Journal of Cancer 136 (5) E359-E386.

Mols, F., Korfage, I.J., Vingerhoets, A.J.J.M., Kil, P.J.M., Coebergh, J.W.W., Essink-Bot, M-L. & van de Poll-Franse, L.V. (2009). Bowel, Urinary, and Sexual Problems Among Long-Term Prostate Cancer Survivors: A Population-Based Study. International Journal of Radiation Oncology Biology Physics 73 (1) 30-38.

Bellardita, L., Valdagni, R., van den Bergh, R., Randsdorp, H., Repetto, C., Venderbos, L.D.F., Lane, J.A. & Korfage, I.J. (2015). How Does Active Surveillance for Prostate Cancer Affect Quality of Life? A Systematic Review. European Urology 67 (4) 637-645.

Punnen, S., Cowan, J.E., Chan, J.M., Carroll, P.R. & Cooperberg, M.R. (2015). Long-term Health-related Quality of Life After Primary Treatment for Localized Prostate Cancer: Results from the CaPSURE Registry. European Urology 68 (4) 600-608.

Heidenreich, A., Bastian, P.J., Bellmunt, J., Bolla, M., Joniau, S., van der Kwast, T., Mason, M., Matveev, V., Wiegel, T., Zattoni, F., Mottet, F. & European Association of Urology. (2014). EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent—update 2013. European Urology 65 (1) 124-137.

Cuypers, M., Lamers, R.E.D., Kil, P.J.M., The, R., Karssen, K., van de Poll-Franse, L.V. & de Vries, M. (2017). A global, incremental development method for a web-based prostate cancer treatment decision aid and usability testing in a Dutch clinical setting. Health Informatics doi: 10.1177/1460458217720393.

Cuypers, M., Lamers, R.E.D., Kil, P.J.M., van de Poll-Franse, L.V. & de Vries, M. (2015). Impact of a web-based treatment decision aid for early-stage prostate cancer on shared decision-making and health outcomes: study protocol for a randomized controlled trial. Trials 16 (1) 1-10.

Fleuren, M.A., Paulussen, T.G., Van Dommelen, P. & Van Buuren, S. (2014). Towards a measurement instrument for determinants of innovations. International Journal for Quality Health Care 26 (5) 501-510.

Fleuren, M., Paulussen, T., Van Dommelen, P. & Van Buuren, S. (2012). Meetinstrument voor determinanten van innovaties (MIDI). Leiden: TNO.

Rozema, A.D., Mathijssen, J.J.P., Jansen, M.W.J. & van Oers, J.A.M. (2016). Schools as smoke-free zones? Barriers and facilitators to the adoption of outdoor school ground smoking bans at secondary schools. Tobacco Induced Diseases 14 (1) 10.

Sijpkens, M.K., Steegers, E.A.P. & Rosman, A.N. (2016). Facilitators and Barriers for Successful Implementation of Interconception Care in Preventive Child Health Care Services in the Netherlands. Maternal and Child Health Journal 20 (1) 117-124.

Grol, R. & Wensing, M. (2004). What drives change? Barriers to and incentives for achieving evidence-based practice. Medical Journal of Australia 180 (Supplement 6) S57-60.

Lamers, R.E.D., Cuypers, M., de Vries, M., van de Poll-Franse, L.V., Ruud Bosch, J.L.H. & Kil, P.J.M. (2016). How do patients choose between active surveillance, radical prostatectomy, and radiotherapy? The effect of a preference-sensitive decision aid on treatment decision making for localized prostate cancer. Urologic Oncology: Seminars and Original Investigations.

Feldman-Stewart, D., Tong, C., Siemens, R., Alibhai, S., Pickles, T., Robinson, J. & Brundage, M.D. (2012). The Impact of Explicit Values Clarification Exercises in a Patient Decision Aid Emerges After the Decision Is Actually Made: Evidence From a Randomized Controlled Trial. Medical Decision Making 32 (4) 616-626.

Légaré, F. & Thompson-Leduc, P. (2014). Twelve myths about shared decision making. Patient Education and Counseling 96 (3) 281-286.

Sepucha, K.R., Simmons, L.H., Barry, M.J., Edgman-Levitan, S., Licurse, A.M. & Chaguturu, S.K. (2016). Ten Years, Forty Decision Aids, And Thousands Of Patient Uses: Shared Decision Making At Massachusetts General Hospital. Health Affairs 35 (4) 630-636.

Agoritsas, T., Heen, A.F., Brandt, L., Alonso-Coello, P., Kristiansen, A., Akl, E.A., Neumann, I., Tikkinen, K.A., Weijden, T., Elwyn, G., Montori, V.M., Guyatt, G.H. & Vandvik, P.O. (2015). Decision aids that really promote shared decision making: the pace quickens. British Medical Journal 350, g7624.

Durand, M-A., Barr, P.J., Walsh, T. & Elwyn, G. (2015). Incentivizing shared decision making in the USA - where are we now? Healthcare 3 (2) 97-101.

Al-Itejawi, H.H.M., van Uden-Kraan, C.F., Vis, A.N., Nieuwenhuijzen, J.A., Hofstee, M.J.A., van Moorselaar, R.J.A. & Verdonck-de Leeuw, I.M. (2016). Development of a patient decision aid for the treatment of localised prostate cancer: a participatory design approach. Journal of Clinical Nursing 25 (7-8) 1131-1144.

van Tol-Geerdink, J.J., Willem Leer, J., Weijerman, P.C., van Oort, I.M., Vergunst, H., van Lin, E.N., Alfred Witjes, J. & Stalmeier, P.F. (2013). Choice between prostatectomy and radiotherapy when men are eligible for both: a randomized controlled trial of usual care vs decision aid. BJU International 111 (4) 564-573.

Elwyn, G., Frosch, D., Thomson, R., Joseph-Williams, N., Lloyd, A., Kinnersley, P., Cording, E., Tomson, D., Dodd, C., Rollnick, S., Edwards, A. & Barry, M. (2012). Shared decision making: a model for clinical practice. Journal of General Internal Medicine 27 (10) 1361-1367.

Gravel, K., Légaré, F. & Graham, I. (2006). Barriers and facilitators to implementing shared decision-making in clinical practice: a systematic review of health professionals’ perceptions. Implementation Science 1, 16.

Lamers, R.E.D., Cuypers, M., Husson, O., de Vries, M., Kil, P.J.M., Ruud Bosch, J.L.H. & van de Poll-Franse, L.V. (2016). Patients are dissatisfied with information provision: perceived information provision and quality of life in prostate cancer patients. Psycho-Oncology 25 (6) 633-640.

Elkin, E.B., Kim, S.H.M., Casper, E.S., Kissane, D.W. & Schrag, D. (2007). Desire for Information and Involvement in Treatment Decisions: Elderly Cancer Patients' Preferences and Their Physicians' Perceptions. Journal of Clinical Oncology 25 (33) 5275-5280.



  • There are currently no refbacks.