15250-m-cuypers

191 JIPPA evaluation 10 INTRODUCTION Prostate cancer (Pca) is the most common malignancy diagnosed in men in the western world. In case of localized prostate cancer, patients are typically required to choose between multiple equivalent treatment options. Although survival perspectives with each treatment are similar, treatment procedures and risk for side-effects vary, andmany patients have poor understanding of these differences between treatments 1 . Therefore, clinical guidelines concerning localized Pca suggest a shared patient-doctor decision to incorporate patient preferences and values into the treatment decision 2-5 . Decision aids (DAs) have been developed to assist patients and care providers with shared decision making (SDM) 6 . Evidence for the beneficial effects of applying DAs is widely available and shows that patients have better knowledge of the treatment options, and are more aware of their personal preferences and values 7 . As a consequence, DAs help patients to take a more active role in the decision-making process 8 . So far, most DA trials, including those related to Pca treatment, focused on determining the DA effects, with limited attention for implementation aspects 7, 9 . Many DA trials took place within a single institution or location, and even if the absolute number of the DAs distributed was known, their relative reach within the targeted patient population often remained unknown 10, 11 . Moreover, uptake of DAs in daily routine, outside of clinical trials, is low, resulting in limited knowledge about successful DA implementation at a large scale 7, 12-17 . After distribution of the DA to eligible patients, the next step in implementation is actual DA use by patients. Patient-perceived barriers and facilitators related to DA usage, have been studied more extensively 13, 18-22 . Common barriers against DA usage from the patients’ perspective are insufficient trust in the DA quality or its benefits, the DA being unpractical in use, inadequate timing (e.g. the DA being offered too late after diagnosis) or inadequate explanation of how to use the DA. Patient-perceived facilitators include that the DA is practical in use, and that the presented information is complete and trusted 13, 18-22 . With the current implementation study, we aimed to investigate the implementation rate of these three DAs in routine Pca care in the Netherlands, and aimed to identify possible barriers and facilitators from the patients´ perspective. This study was conducted by the Joint Implementation Prostate cancer Patient-centered care (JPPPA) consortium, consisting of three DA research groups that each developed a DA for Pca patients.