A Single Educational Seminar Increases Confidence and Decreases Dropout from Active Surveillance by 5 Years After Diagnosis of Prostate Cancer.
Authors of this article are:
Kinsella N, Beckmann K, Cahill D, Elhage O, Popert R, Cathcart P, Challacombe B, Brown C, Van Hemelrijck M.
A summary of the article is shown below:
BACKGROUND: Researchers remain divided on the major causes of dropout from active surveillance (AS), with rates of up to 38% among men with no evidence of prostate cancer (PC) progression.OBJECTIVE: To develop and evaluate an educational intervention in terms of adherence to AS among men with low- to intermediate-risk PC.DESIGN, SETTING, AND PARTICIPANTS: We first carried out focus group discussions with men who had remained on and dropped out of AS to inform an intervention to increase adherence to AS. A total of 255 consecutive men who had selected AS were then recruited to either standard care (written information and access to a nurse specialist) or standard care and the intervention.INTERVENTION: An educational seminar was designed by patients and clinicians including information on imaging, biopsy techniques, understanding pathology, large AS cohorts – mortality and morbidity risk and diet and lifestyle advice.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The proportion of men dropping out of AS for reasons other than disease progression was assessed at 1 and 5yr after AS selection using multivariate logistic regression.RESULTS AND LIMITATIONS: Common themes influencing decision-making by men on AS were identified: (1) clinical consistency; (2) information; and (3) lifestyle advice. Addition of an educational seminar led to significantly fewer men dropping out of AS: at 1 and 5yr the dropout rate was 25% and 42%, respectively, in the standard care group, compared to 11% and 22% (p=0.001) in the intervention group. In the intervention group, 18 men failed to attend the seminar.CONCLUSIONS: The AS dropout rate was halved following a single educational seminar delivered to groups of men with intermediate- or low-risk PC, even at 5yr.PATIENT SUMMARY: Men on active surveillance (AS) for prostate cancer feel more supported when provided with an educational seminar within 3 mo of their treatment choice. The seminar halved the number of men dropping-out of AS, even at 5yr.Copyright © 2018 European Association of Urology. Published by Elsevier B.V. All rights reserved.
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This article is a good source of information and a good way to become familiar with topics such as: Active surveillance;Adherence;Intervention;Prostate cancer.