15250-m-cuypers

175 Decision aid uptake and usage in clinical practice 9 Patients accessed the DA with an individual access code that was provided to them on a card by their care provider. On that card, the care provider also indicated which of the treatments covered by the DA (AS, radical prostatectomy, brachytherapy, and external beam radiotherapy) were eligible for the patient. For gathering DA user data, receiving the post-questionnaire, and combining DA user data and questionnaire data, patients signed informed consent. The DA could be used by patients regardless of trial participation and consent, DA usage was then still monitored, as this was anonymized data not linked to individual patients. Decision aid The DA is in Dutch language and available online-only after login (http://prostaat. keuzehulp.nl ). After accessing the DA, patients are presented with general information about Pca and treatments first. Based on the treatments available to the patient, detailed information is then provided about all treatments. Information about treatments is broken up into a section about active surveillance versus treatment, and a section about survery versus radiotherapy. Per section, values clarification exercises (VCEs) are included toelicit patient preferences for treatment.TheseVCEs arepresentedas tradeoffs between treatment attributes. The DA ends with a summary of all indicated preferences, including a treatment preference. The DA summary can be printed and brought to the following consultation with their clinician, or re-accessed online, to enable a shared patient-doctor conversation about aspects relevant to the patient. The development process and DA content (including examples of the VCEs and DA summary page) have been described in more detail before 16 . Data collection and patient questionnaires For this study, data was gathered on the number of DAs provided by healthcare providers and the usage of the DA by patients. As the DA was provided as part of a RCT, both healthcare providers and patients signed informed consent. Study numbers on the informed consent forms were hospital specific and linked to the DA access codes. An informed consent signed by a healthcare provider represented a DA being provided to a patient; actual patient use of the DA was monitored by means of log files. Data from the questionnaires were linked to DA user data based on study number. Patient characteristics from informed consent were saved separately from the DA user data to ensure anonymity. To determine the degree of implementation, information on the total number of eligible Pca patients per hospital was obtained from The Netherlands Cancer Registry (NCR) for a five year period (2009-2013) prior to the start of DA implementation. All