Primary Care Physician Perspectives on Low Risk Prostate Cancer Management: Results of a National Survey.
Primary Care Physician Perspectives on Low Risk Prostate Cancer Management: Results of a National Survey.
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初级保健医生对低风险前列腺癌管理的看法：全国调查结果。
DOI：
10.1097/upj.0000000000000231
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发表时间：
2021
期刊：
影响因子：
0.8
通讯作者：
Hawley,SarahT
中科院分区：
文献类型：
--
作者：
Radhakrishnan,Archana;Wallner,LaurenP;Skolarus,TedA;Shahinian,VahaknB;Abrahamse,PaulH;Fetters,MichaelD;Hawley,SarahT
简介初级保健提供者可以与泌尿科医生合作，确保接受主动监测的低风险前列腺癌男性接受随访检测并遵守管理策略，但初级保健提供者对主动监测的态度及其作用仍然未知。方法我们调查了 1,000 名初级保健提供者（347/741 合格的初级保健提供者进行了回应）。我们评估了初级保健提供者对主动监测的支持和信念，以及对其在低风险前列腺癌管理各个方面的作用的态度和偏好。然后，我们研究了 1) 初级保健提供者对主动监测的支持和初级保健提供者对主动监测的信念之间的关联； 2) 初级保健提供者对其角色的态度和偏好。结果近 50% 的初级保健提供者强烈支持对所有低风险男性进行主动监测，81% 的人强烈认为主动监测可以让男性避免副作用，而 57% 的人强烈认为这会引起担忧。强烈支持主动监测的初级保健提供者不太可能强烈同意主动监测会导致担忧（分别为 50.3% 和 63.7%，p=0.01）。一半的初级保健提供者强烈同意初级保健提供者可以提供癌症相关护理（50.5%），大多数人更喜欢共享护理模式而不是订购前列腺特异性抗原测试（60.1%）。与泌尿科医生主导的前列腺特异性抗原检测相比，强烈同意初级保健提供者可以提供癌症相关护理的初级保健提供者更有可能更喜欢初级保健提供者主导的（79.3% vs 20.7%）或共享护理（53.9% vs 46.1%）模式（p <0.01）。结论虽然许多初级保健提供者支持对低风险前列腺癌进行主动监测，但初级保健提供者仍然对其作为主要管理策略表示担忧。了解初级保健提供者对低风险前列腺癌管理的看法可以为改善高质量主动监测护理的策略提供信息。
IntroductionPrimary care providers can collaborate with urologists to ensure men with low risk prostate cancer on active surveillance receive followup testing and adhere to the management strategy, yet primary care provider attitudes about active surveillance and their roles remain unknown.MethodsWe surveyed 1,000 primary care providers (347/741 eligible primary care providers responded). We assessed primary care provider support for and beliefs about active surveillance, and attitudes about and preferences for their role in various aspects of low risk prostate cancer management. We then examined associations between 1) primary care provider support for and primary care provider beliefs about active surveillance; and 2) primary care provider attitudes and preferences for their role.ResultsNearly 50% of primary care providers strongly supported active surveillance for all low risk men, and 81% strongly agreed that active surveillance allows men to avoid side effects, while 57% strongly agreed it caused worry. Primary care providers who strongly supported active surveillance were less likely to strongly agree that active surveillance contributes to worry (50.3% vs 63.7% respectively, p=0.01). Half of the primary care providers strongly agreed that primary care providers can provide cancer-related care (50.5%), and the majority preferred a shared care model to ordering prostate specific antigen tests (60.1%). Primary care providers who strongly agreed that primary care providers can provide cancer-related care were more likely to prefer a primary care provider-led (79.3% vs 20.7%) or shared care (53.9% vs 46.1%) model vs urologist-led for ordering prostate specific antigen tests (p <0.01).ConclusionsWhile many primary care providers supported active surveillance for low risk prostate cancer, primary care providers still had concerns with it as the primary management strategy. Understanding primary care providers perspectives on low risk prostate cancer management can inform strategies to improve high quality active surveillance care.