Over the last decade, active surveillance has proven to be a safe approach for patients with low-risk prostate cancer. Although active surveillance presents several advantages for both patients and the health care system, all eligible patients do not adopt this approach.
Our goal was to evaluate the factors that influence physicians to recommend active surveillance and the barriers that impact adherence to this approach.
Focus groups (n = 5) were held with physicians who provided care for men with low-risk prostate cancer and had engaged in conversations with men and their families about active surveillance. The experience of health care professionals (HCPs) was captured to understand their decisions in proposing active surveillance and to reveal the barriers and facilitators that affect the adherence to this approach. A content analysis was performed on the verbatim transcripts from the sessions.
Although physicians agreed that active surveillance is a suitable approach for low-risk prostate cancer patients, they were concerned about the rapidly evolving and non-standardized guidelines for patient follow-up. They pointed out the need for additional tools to appropriately identify proper patients for whom active surveillance is the best option. Urologists and radiation-oncologists were keen to collaborate with each other, but the role of general practitioner remained controversial once patients were referred to a specialist.
Integration of more reliable tools and/or markers in addition to more specific guidelines for patient follow-up would increase the confidence of both patients and physicians in the choice of active surveillance.
BMC health services research. 2018 Jun 08*** epublish ***
Kittie Pang, Margaret Fitch, Veronique Ouellet, Simone Chevalier, Darrel E Drachenberg, Antonio Finelli, Jean-Baptiste Lattouf, Alan So, Simon Sutcliffe, Simon Tanguay, Fred Saad, Anne-Marie Mes-Masson
Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Toronto, ON, Canada., Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada., Institut du cancer de Montréal and Centre de recherche du Centre hospitalier de l'Université de Montréal, 900, St Denis St, Montréal, QC, Canada., McGill University and McGill University Health Centre, 1001 Decarie Blvd, Montreal, QC, Canada., Manitoba Prostate Centre, 675 McDermot Ave, Winnipeg, MB, Canada., University Health Network, 610 University Ave, Toronto, ON, Canada., Vancouver Prostate Centre, 2660 Oak St, Vancouver, BC, Canada., Terry Fox Research Institute, 675 West 10th Avenue, Vancouver, BC, Canada., Institut du cancer de Montréal and Centre de recherche du Centre hospitalier de l'Université de Montréal, 900, St Denis St, Montréal, QC, Canada. .
PubMed http://www.ncbi.nlm.nih.gov/pubmed/29884180
Go Beyond the Abstract and Read a Commentary by Margaret Fitch, PhD