A Randomized Controlled Effectiveness Trial for PSA Screening Decision Support Interventions in Two Primary Care Settings.
J Gen Intern Med
; 30(6): 810-6, 2015 Jun.
Article
em En
| MEDLINE
| ID: mdl-25666221
ABSTRACT
BACKGROUND:
Decision support interventions (DESIs) provide a mechanism to translate comparative effectiveness research results into clinical care so that patients are able to make informed decisions. Patient decision support interventions for prostate-specific antigen (PSA) have been shown to promote informed decision making and reduce PSA testing in efficacy trials, but their impact in real world settings is not clear.OBJECTIVE:
We performed an effectiveness trial of PSA decision support interventions in primary care.DESIGN:
A randomized controlled trial of three distribution strategies was compared to a control.PARTICIPANTS:
Participants included 2,550 men eligible for PSA testing (76.6 % of the eligible population) and 2001 survey respondents (60.1 % survey response rate).INTERVENTIONS:
The intervention groups were 1) mailed the DESI in DVD format, 2) offered a shared medical appointment (SMA) to view the DESI with other men and discuss, and 3) both options. MAINMEASURES:
We measured PSA testing identified via electronic medical record at 12 months and DESI use by self-report 4 months after the intervention mailing. KEYRESULTS:
We found no differences in PSA testing across the three distribution strategies over a year-long follow-up period 21 %, 24 %, 22 % in the DESI, SMA, and combined group respectively, compared to 21 % in the control group (p = 0.51). Self-reported DESI use was low across all strategies at 4 months 16 % in the mailed DESI group, 6 % in the SMA group, and 15 % in the combined group (p = < 0.0001).CONCLUSIONS:
Mailing PSA decision support interventions or inviting men to shared medical appointments unrelated to a primary care office visit do not appear to promote informed decision making, or change PSA testing behavior.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Atenção Primária à Saúde
/
Neoplasias da Próstata
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Calicreínas
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Técnicas de Apoio para a Decisão
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Antígeno Prostático Específico
Tipo de estudo:
Clinical_trials
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Diagnostic_studies
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Prognostic_studies
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Screening_studies
Limite:
Aged
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2015
Tipo de documento:
Article