MP43-02: Preference elicitation and treatment decision making among men diagnosed with localized prostate cancer: Results from the Healium Trial.

Michael Diefenbach*, Simon Hall, Manish Vira, Michael Schwartz, New Hyde Park, NY, Erin Tagai, Alexander Kutikov, Andres Correa, Philadelphia, PA, Halie Pfister, Andrea Yacoub, Manhasset, NY, Suzanne Miller, Philadelphia, PA

Introduction: Treatment decision-making for localized prostate cancer is complex and is influenced by on patients’ personal preferences.  Although important, personal preferences are rarely comprehensively assessed in the clinical encounter and incorporated in the treatment selection process.  Ignoring of patient preferences has been associated with higher levels of decisional conflict and decisional regret. 

Objective: To evaluate Healium, a brief interactive tool to aide men diagnosed with localized prostate cancer in preference identification and medical decision-making, in a randomized controlled trial.

Methods: Men diagnosed with localized prostate cancer (N=281) recruited from two hospitals were randomized to receive Healium or, matched for time and attention, the Healing Choices for men with prostate cancer, an established online education tool.  Healium can be completed in 10 minutes or less and focuses on treatment preferences.  Healing choices’ content, can takes several hours to explore.   The programs were introduced prior to a consultation with the physician.  Decisional conflict, the primary outcome variable, was assessed at baseline, at 6 weeks and 3 months.

Results: Men were on average 64 years old (SD=6.93), 25% minority; 78% married; and had a bachelor’s degree or below (73.4%).  At baseline mean decisional conflict was 36.06 (SD=28) for Healium and 32.96 (SD=24.52) for Healing Choices, indicating moderate decisional conflict (range 0-100; 100 extreme conflict).  At six weeks post consultation decisional conflict decreased significantly in both conditions: 7.13 (SD=15.26) for Healium; 6.61 (SD=13.04) for Healing Choices; (F(1,213) = 0.068; ns).  We found no differences in decisional conflict subscales by intervention type or any moderating effect of age, education, or race.

Conclusions: Software education programs such as Healium or Healing Choices significantly decrease treatment decisional conflict among men diagnosed with prostate cancer.  The short time it takes to complete Healium and its effectiveness, however, makes it an ideal tool for use in clinical practice.  Integration into the electronic medical health records and a guide for clinicians to discuss patient preferences are next steps in the implementation of the program.

Source of Funding: American Cancer Society, Research Scholar Award (RSG-15-021-01-CPPB)