Daniel H. Kwon, Lauren Trihy, Nika Darvish, Eliza Hearst, Saffanat Sumra, Hala T. Borno, Rohit Bose, Jonathan Chou, Ivan de Kouchkovsky, Arpita Desai, Brad Ekstrand, Terence Friedlander, Gurleen Kaur, Vadim S. Koshkin, Samantha Nesheiwat, Karen Sepucha, Eric J. Small, Rahul R. Aggarwal, Jeffrey Belkora
{"title":"患者可进行移动录音，以增加对晚期前列腺癌的了解。","authors":"Daniel H. Kwon, Lauren Trihy, Nika Darvish, Eliza Hearst, Saffanat Sumra, Hala T. Borno, Rohit Bose, Jonathan Chou, Ivan de Kouchkovsky, Arpita Desai, Brad Ekstrand, Terence Friedlander, Gurleen Kaur, Vadim S. Koshkin, Samantha Nesheiwat, Karen Sepucha, Eric J. Small, Rahul R. Aggarwal, Jeffrey Belkora","doi":"10.1002/cam4.70433","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>Consultation audio recordings improve patient decision-making but are underutilized. Patient-administered recording apps on mobile devices may increase access, but implementation has not been evaluated.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We conducted a single-arm study delivering education, coaching, and reminders for patients to record their appointment using a mobile recording app. Patients had progressive, advanced prostate cancer and an upcoming appointment where the option of docetaxel would be discussed. We used the RE-AIM framework for evaluation. Reach was the proportion of patients who participated. Effectiveness was change in informed decision-making pre- vs. post-appointment. We used a questionnaire evaluating patient knowledge about docetaxel (0%–100% correct) and the decisional conflict scale-informed subscale (0 = feels extremely uninformed to 100 = extremely informed) to compare means using the paired <i>t</i>-test. Adoption was the proportion of providers agreeing to be recorded. Implementation was coordinator adherence to intervention delivery. We conducted semistructured interviews with patients, caregivers, and providers to assess barriers, facilitators, and suggestions for recording implementation.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Of 102 patients approached, 50 (49%) patients participated. Mean age was 75 years, 38 (76%) were Non-Hispanic White, and 43 (86%) had telehealth appointments. Knowledge increased from 44.7% to 49.5% (<i>p</i> = 0.019), particularly about palliative care (42% answering correctly to 60%, <i>p</i> = 0.035). Decisional conflict-informed subscale increased from 48.9 to 70.9 (<i>p</i> < 0.001). Forty-three patients (85%) made a recording, of whom 33 (77%) reported the recording helped treatment decision-making. All 17 providers agreed to be recorded. Coordinator adherence was high. Multi-level barriers, suggestions, and facilitators mostly related to intervention complexity and stakeholder compatibility.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Patient-administered audio recordings had a positive effect on decision-making, particularly for palliative care awareness. For broader implementation, efforts should focus on revising institutional policies; teaching patients or caregivers to use existing recording functions on their devices; leveraging artificial intelligence for transcription and summarization; and integrating recording into telehealth technology and electronic patient portals.</p>\n \n <p><b>Trial Registration:</b> https://clinicaltrials.gov/study/NCT05127850</p>\n </section>\n </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"13 22","pages":""},"PeriodicalIF":2.9000,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70433","citationCount":"0","resultStr":"{\"title\":\"Patients Can Administer Mobile Audio Recordings to Increase Knowledge in Advanced Prostate Cancer\",\"authors\":\"Daniel H. Kwon, Lauren Trihy, Nika Darvish, Eliza Hearst, Saffanat Sumra, Hala T. 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Reach was the proportion of patients who participated. Effectiveness was change in informed decision-making pre- vs. post-appointment. We used a questionnaire evaluating patient knowledge about docetaxel (0%–100% correct) and the decisional conflict scale-informed subscale (0 = feels extremely uninformed to 100 = extremely informed) to compare means using the paired <i>t</i>-test. Adoption was the proportion of providers agreeing to be recorded. Implementation was coordinator adherence to intervention delivery. We conducted semistructured interviews with patients, caregivers, and providers to assess barriers, facilitators, and suggestions for recording implementation.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Of 102 patients approached, 50 (49%) patients participated. Mean age was 75 years, 38 (76%) were Non-Hispanic White, and 43 (86%) had telehealth appointments. 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Patients Can Administer Mobile Audio Recordings to Increase Knowledge in Advanced Prostate Cancer
Introduction
Consultation audio recordings improve patient decision-making but are underutilized. Patient-administered recording apps on mobile devices may increase access, but implementation has not been evaluated.
Methods
We conducted a single-arm study delivering education, coaching, and reminders for patients to record their appointment using a mobile recording app. Patients had progressive, advanced prostate cancer and an upcoming appointment where the option of docetaxel would be discussed. We used the RE-AIM framework for evaluation. Reach was the proportion of patients who participated. Effectiveness was change in informed decision-making pre- vs. post-appointment. We used a questionnaire evaluating patient knowledge about docetaxel (0%–100% correct) and the decisional conflict scale-informed subscale (0 = feels extremely uninformed to 100 = extremely informed) to compare means using the paired t-test. Adoption was the proportion of providers agreeing to be recorded. Implementation was coordinator adherence to intervention delivery. We conducted semistructured interviews with patients, caregivers, and providers to assess barriers, facilitators, and suggestions for recording implementation.
Results
Of 102 patients approached, 50 (49%) patients participated. Mean age was 75 years, 38 (76%) were Non-Hispanic White, and 43 (86%) had telehealth appointments. Knowledge increased from 44.7% to 49.5% (p = 0.019), particularly about palliative care (42% answering correctly to 60%, p = 0.035). Decisional conflict-informed subscale increased from 48.9 to 70.9 (p < 0.001). Forty-three patients (85%) made a recording, of whom 33 (77%) reported the recording helped treatment decision-making. All 17 providers agreed to be recorded. Coordinator adherence was high. Multi-level barriers, suggestions, and facilitators mostly related to intervention complexity and stakeholder compatibility.
Conclusion
Patient-administered audio recordings had a positive effect on decision-making, particularly for palliative care awareness. For broader implementation, efforts should focus on revising institutional policies; teaching patients or caregivers to use existing recording functions on their devices; leveraging artificial intelligence for transcription and summarization; and integrating recording into telehealth technology and electronic patient portals.
期刊介绍：
Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas:
Clinical Cancer Research
Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations
Cancer Biology:
Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery.
Cancer Prevention:
Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach.
Bioinformatics:
Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers.
Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.
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