15250-m-cuypers

194 Chapter 10 Outcome measures Our primary outcome measure was the implementation rate. This rate was calculated by the proportion of patients who received a DA compared to the estimated total number of eligible Pca patients per hospital during the period the DA was implemented. Since the total number of eligible patients was not prospectively registered in a structured manner in all participating hospitals, an estimation was based on hospital-specific registry data of the six years prior to the current project, retrieved from the Netherlands Cancer Registry. After a treatment decision was made, a questionnaire was used to collect self-reported data about patient’s demographic variables (age, marital status, having children and educational level). Evaluation measures consisted of DA distribution procedures (e.g. ‘Who presented the DA to you?’), DA user-friendliness (e.g. ‘Did it occur fonts were too small?’), and a 24-item list of barriers and facilitators for DA use (e.g. ‘I had insufficient trust in the DA’) based on literature 22 (items presented in Table 3). All three DA groups used the same questionnaires to evaluate DA use in order to enable combined data analyses. Data analysis Descriptive questionnaire data are presented as means ( M s) with standard deviations ( SD s) for continuous variables, and frequencies and percentages for categorical variables. Comparisons between DAs for continuous variables were made with analyses of variance (ANOVA) and Bonferroni post-hoc tests and with chi-square tests for categorical variables. Statistical analyses were conducted with SPSS 22.0 (Statistical Package for Social Sciences, Chicago, IL). Tests were two-sided and considered statistically significant if p <.05. RESULTS During the study period, 908 newly diagnosed Pca patients received a DA out of an estimated total of 2,285 eligible patients, resulting in an overall implementation rate of 40%. With each DA, high implementation levels (>80%) were achieved in 1 or 2 hospitals, whereas for the other hospitals implementation varied considerably (2- 80%). Highest average implementation was achieved with the concise paper DA1 (60%), average implementation levels for DA2 and DA3 were comparable (34-35%). Implementation rates across hospitals for each DA are presented in Figure 1.