Shared Decision-Making and Cardiovascular Complications of Androgen Deprivation Therapy: an Educational Initiative for Oncology Team Members in Colorado, USA

Overview

Journal J Cancer Educ

Publisher Springer

Specialties Medical Education
Oncology

Date 2024 Mar 15

PMID 38488958

Authors

Rovshan M Ismailov

Alvaro Acena

Zaytuna D Khasanova

Affiliations

Soon will be listed here.

Abstract

Patients with prostate cancer may experience side effects of androgen deprivation therapy (ADT) such as cardiovascular (CV) complications. Oncology team members should actively communicate with patients about these complications. On the other hand, shared decision-making (SDM) has been shown to improve patient-physician communication. We developed brochures focused on CV complications of ADT and SDM. We proceeded to deliver these brochures to participating oncology offices and then carried out a survey of team members in these offices. We obtained responses from 31 oncology team members. Our survey revealed that about half of the participants (48%) rarely applied SDM in their oncology practice, and only about one-third (32%) sometimes applied SDM. After reading our brochures, the majority of respondents could correctly answer questions about SDM and CV complications of ADT. Improvement in scores after reading our materials was significant for both CV complications of ADT and SDM (e.g., CV complications of ADT: z = 6.153, p-value < 0.001, and SDM z = 6.456, p-value < 0.001). Implementation of SDM and an improved awareness of the CV complications of ADT can lead to significant benefits. It is therefore important to take steps to further raise such implementation and awareness among oncology team members in other geographic locations and clinical settings.

References

Kakarla M, Ausaja Gambo M, Yousri Salama M, Ismail N, Tavalla P, Uppal P . Cardiovascular Effects of Androgen Deprivation Therapy in Prostate Cancer Patients: A Systematic Review. Cureus. 2022; 14(6):e26209. PMC: 9307258. DOI: 10.7759/cureus.26209. View

Aoun F, Bourgi A, Ayoub E, El Rassy E, van Velthoven R, Peltier A . Androgen deprivation therapy in the treatment of locally advanced, nonmetastatic prostate cancer: practical experience and a review of the clinical trial evidence. Ther Adv Urol. 2017; 9(3-4):73-80. PMC: 5378097. DOI: 10.1177/1756287217697661. View

Liang Z, Zhu J, Chen L, Xu Y, Yang Y, Hu R . Is androgen deprivation therapy for prostate cancer associated with cardiovascular disease? A meta-analysis and systematic review. Andrology. 2019; 8(3):559-574. DOI: 10.1111/andr.12731. View

Carneiro A, Sasse A, Wagner A, Peixoto G, Kataguiri A, Serpa Neto A . Cardiovascular events associated with androgen deprivation therapy in patients with prostate cancer: a systematic review and meta-analysis. World J Urol. 2014; 33(9):1281-9. DOI: 10.1007/s00345-014-1439-6. View

Collier A, Ghosh S, McGlynn B, Hollins G . Prostate cancer, androgen deprivation therapy, obesity, the metabolic syndrome, type 2 diabetes, and cardiovascular disease: a review. Am J Clin Oncol. 2011; 35(5):504-9. DOI: 10.1097/COC.0b013e318201a406. View

Jin C, Fan Y, Meng Y, Shen C, Wang Y, Hu S . A meta-analysis of cardiovascular events in intermittent androgen-deprivation therapy versus continuous androgen-deprivation therapy for prostate cancer patients. Prostate Cancer Prostatic Dis. 2016; 19(4):429. DOI: 10.1038/pcan.2016.48. View

Woodhouse K, Tremont K, Vachani A, Schapira M, Vapiwala N, Simone 2nd C . A Review of Shared Decision-Making and Patient Decision Aids in Radiation Oncology. J Cancer Educ. 2017; 32(2):238-245. DOI: 10.1007/s13187-017-1169-8. View

Veenendaal H, Chernova G, Bouman C, van Etten-Jamaludin F, van Dieren S, Ubbink D . Shared decision-making and the duration of medical consultations: A systematic review and meta-analysis. Patient Educ Couns. 2022; 107:107561. DOI: 10.1016/j.pec.2022.11.003. View

van der Horst D, Garvelink M, Bos W, Stiggelbout A, Pieterse A . For which decisions is Shared Decision Making considered appropriate? - A systematic review. Patient Educ Couns. 2022; 106:3-16. DOI: 10.1016/j.pec.2022.09.015. View

10.

Maes-Carballo M, Garcia-Garcia M, Gomez-Fandino Y, Estrada-Lopez C, Iglesias-Alvarez A, Bueno-Cavanillas A . Systematic review of shared decision-making in guidelines about colorectal cancer screening. Eur J Cancer Care (Engl). 2022; 31(6):e13738. PMC: 9786598. DOI: 10.1111/ecc.13738. View

11.

Hoffman R, Elmore J, Fairfield K, Gerstein B, Levin C, Pignone M . Lack of shared decision making in cancer screening discussions: results from a national survey. Am J Prev Med. 2014; 47(3):251-9. DOI: 10.1016/j.amepre.2014.04.011. View

12.

Ismailov R, Pouillon L, Selinger C, Khasanova Z . Knowledge and awareness of biosimilars and shared decision-making among gastroenterology team members in Colorado, USA. Expert Opin Biol Ther. 2020; 21(1):111-119. DOI: 10.1080/14712598.2020.1842355. View

13.

Johansen N, Miserez M, de Beaux A, Montgomery A, Faylona J, Carbonell A . Surgical Strategy for Contralateral Groin Management in Patients Scheduled for Unilateral Inguinal Hernia Repair: An International Web-Based Surveymonkey Questionnaire: Strategy for Contralateral Groin Management during Inguinal Hernia Repair. Scand J Surg. 2020; 110(3):368-372. DOI: 10.1177/1457496920938600. View

14.

Bramstedt K, Ierna B, Woodcroft-Brown V . Using SurveyMonkey® to teach safe social media strategies to medical students in their clinical years. Commun Med. 2015; 11(2):117-24. DOI: 10.1558/cam.v11i2.27556. View

15.

George D, Dreibelbis T, Aumiller B . Google Docs and SurveyMonkey™: lecture-based active learning tools. Med Educ. 2013; 47(5):518. DOI: 10.1111/medu.12172. View

16.

Caverly T, Hayward R . Dealing with the Lack of Time for Detailed Shared Decision-making in Primary Care: Everyday Shared Decision-making. J Gen Intern Med. 2020; 35(10):3045-3049. PMC: 7572954. DOI: 10.1007/s11606-020-06043-2. View

17.

Savelberg W, Boersma L, Smidt M, Goossens M, Hermanns R, van der Weijden T . Does lack of deeper understanding of shared decision making explains the suboptimal performance on crucial parts of it? An example from breast cancer care. Eur J Oncol Nurs. 2019; 38:92-97. DOI: 10.1016/j.ejon.2018.12.004. View

18.

Atalar K, Rajan P . Understanding and managing the cardiovascular risks of androgen deprivation therapy for prostate cancer. Nat Rev Urol. 2022; 20(1):3-4. DOI: 10.1038/s41585-022-00671-5. View

19.

Toste J . Knowing the true nature of the cardiovascular effects of androgen deprivation therapy in prostate cancer: We still have a way to go…. Rev Port Cardiol. 2022; 41(7):603-604. DOI: 10.1016/j.repc.2022.05.003. View

20.

Arnett D, Blumenthal R, Albert M, Buroker A, Goldberger Z, Hahn E . 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2019; 74(10):1376-1414. PMC: 8344373. DOI: 10.1016/j.jacc.2019.03.009. View