Testing of a Tool for Prostate Cancer Screening Discussions in Primary Care.

Misra-Hebert AD1,2,3, Hom G4, Klein EA5, Bauman JM3, Gupta N2, Ji X3, Stephenson AJ5, Jones JS5, Kattan MW3.

Author information

1: Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, United States.
2: Center for Value-Based Care Research, Cleveland Clinic, Cleveland, OH, United States.
3: Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, United States.
4: Case Western Reserve University, Cleveland, OH, United States.
5: Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, United States.

Abstract

BACKGROUND:

As prostate cancer (PCa) screening decisions often occur in outpatient primary care, a brief tool to help the PCa screening conversation in busy clinic settings is needed.

METHODS:

A previously created 9-item tool to aid PCa screening discussions was tested in five diverse primary care clinics. Fifteen providers were recruited to use the tool for 4 weeks, and the tool was revised based upon feedback. The providers then used the tool with a convenience sample of patients during routine clinic visits. Pre- and post-visit surveys were administered to assess patients' knowledge of the option to be screened for PCa and of specific factors to consider in the decision. McNemar's and Stuart-Maxwell tests were used to compare pre-and post-survey responses.

RESULTS:

14 of 15 providers completed feedback surveys and had positive responses to the tool. All 15 providers then tested the tool on 95 men aged 40-69 at the five clinics with 2-10 patients each. The proportion of patients who strongly agreed that they had the option to choose to screen for PCa increased from 57 to 72% (p = 0.018) from the pre- to post-survey, that there are factors in the personal or family history that may affect PCa risk from 34 to 47% (p = 0.012), and that their opinions about possible side effects of treatment for PCa should be considered in the decision from 47 to 61% (p = 0.009).

CONCLUSION:

A brief conversation tool for the PCa screening discussion was well received in busy primary-care settings and improved patients' knowledge about the screening decision.