15250-m-cuypers

180 Chapter 9 From all patients (N=351) receiving a DA, 277 patients accessed the DA (79%; Table 1). Age did not significantly differ between DA users versus non-DA users (65.2 vs 65.6, p =.60). A larger proportion of non-DA users was lower educated, but differences in education level between DA users and non-users did not reach statistical significance. The DA was usedmore often by patients with a Gleason grade 6 tumor (usage rate 92%), compared to patients with a Gleason grade 7 tumor (usage rate 83%, c 2 (1, N =220)=5.18, p <.02; Table 2). DA log file data showed that of 106 patients eligible for AS, 69 patients (65%) read all information about the comparison between AS and treatments, and 163/277 (59%) completed the section about surgery and radiotherapy (all DA users were eligible for at least one of these treatments). The VCEs after the first step (AS versus treatment) were fully completed by 67 of 106 eligible DA users (63%), and after the second step (surgery versus radiotherapy) by 66/277 (24%). A treatment preference was indicated by 197 DA users (71% of all DA users). Usage of the DA elements was consistent among patients from different hospitals (Table 3). The post-decision making questionnaire was sent to 273 patients who gave informed consent (consent rate 78%) and was filled out by 235 respondents (response rate 86%). Questionnaire responders were more likely to have also used the DA (usage rate 86% vs 68%, c 2 (1, N =273)=7.81, p <.01), and where slightly older (62.5 vs 64.9, t (271)=-2.29, p =.02) compared to non-responders. Marital status, educational level, PSA level and Gleason score were collectedwith the questionnaire and therefore not available for non- responders (Table 2). The flow diagram of patients included in this study is presented in Figure 1. From the questionnaire responders who used the DA (N=193), 137 responders (71%) indicated that the summary obtained from the DA, was discussed with their urologist in a subsequent consultation (Table 1). Most respondents indicated that the DA was received within a week from diagnosis (154/208, 74%), and 158 respondents (85%) felt the DA was sufficiently explained (28 respondents indicated no or insufficient explanation was received). One out of four patients received the DA from an (oncology) nurse in, ranging between hospitals from 0 up to two out every three patients. In all other occasions, the DA was received from the urologist. Amajority of the questionnaire responders (163/209, 78%) indicated that the online format of the DA also was the preferred format, 46 responders (22%) would have preferred a paper DA instead (Table 3). Figure 2 presents a flowchart of the most common workflow for DA dissemination across participating hospitals.