Helping patients make informed decisions. Two-year evaluation of the Gustave Roussy prostate cancer multidisciplinary clinic
Helping patients make informed decisions. Two-year evaluation of the Gustave Roussy prostate cancer multidisciplinary clinic
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DOI：
10.1016/j.ctro.2018.07.001
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发表时间：
2018-08-01
影响因子：
3.1
通讯作者：
Blanchard, Pierre
中科院分区：
文献类型：
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作者：
Patrikidou, Anna;Maroun, Pierre;Blanchard, Pierre
目的：新诊断的非转移性前列腺癌的初始治疗决定是复杂的。存在多种有效的方法，对于每一种临床方案都没有明确和绝对的共识，因此专家的意见可能会有所不同。注重共同决策的多学科协商旨在为最初的治疗决策提供一个适当的工具。我们评估了Gustave Roussy前列腺癌多学科诊所(PCMC)最初两年的活动，该诊所致力于非转移性前列腺癌的初步决策。方法：PCMC包括两个连续的与泌尿外科医生和放射肿瘤学家的专家会诊，然后是专门的肿瘤委员会讨论。研究问卷通过邮寄方式发给所有PCMC患者。结果：问卷回复率为69%(134例)。完全满意率很高(118名应答者中114名，97%)。55%的病例向患者提供了新的治疗选择，98%的病例(125名应答者中的122名)感到更了解情况。双重会诊被认为是有用的(129名应答者中有124人，96%)。报告的积极参与感觉显著提高(117名应答者，89%)，而46%的患者(57/125)在PCMC会诊后修改了他们对前列腺癌治疗的决定。结论：在非转移性前列腺癌的初始治疗中，多学科会诊的经验使患者获得了很高的满意度，提高了他们对更知情的感觉的欣赏，促进了积极参与和分享决策，并强烈影响了他们的最终决定。(C)2018年作者。爱思唯尔出版公司(Elsevier B.V.)
Objectives: The initial treatment decision for newly diagnosed non-metastatic prostate cancer is complex. Multiple valid approaches exist, without a clear and absolute consensus for every clinical scenario, and therefore specialist opinions may vary. Multidisciplinary consultations focusing on shared decision-making aim to provide an apposite tool for the initial treatment decision. We have evaluated the first two years of activity of the Gustave Roussy Prostate Cancer Multidisciplinary Clinic (PCMC), dedicated to the initial decision-making for non-metastatic prostate cancer.Methods: PCMC consists of two consecutive specialist consultations with a urological surgeon and a radiation oncologist, followed by a dedicated Tumor Board discussion. A study questionnaire was addressed to all PCMC patients via postal mail. Medical notes and questionnaire responses of 195 eligible patients were analyzed.Results: The questionnaire response rate was 69% (134 patients). Complete satisfaction rate was high (114 of 118 responders, 97%). Patients were offered new treatment options in 55% of cases, and felt better informed in 98% (122 of 125 responders). The double consultation was considered useful (124 of 129 responders, 96%). Reported feeling of active participation was significantly elevated (117 of 131 responders, 89%), while 46% of patients (57 of 125) modified their decision on the management of their prostate cancer following their PCMC consultation.Conclusions: The experience of a multidisciplinary consultation in the initial management of non-metastatic prostate cancer renders high patient satisfaction, improves their appreciation of feeling better informed, promotes active participation and shared decision-making and strongly influences their final decision. (C) 2018 The Authors. Published by Elsevier B.V.