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More information urged for Medicare patients facing preference-sensitive intervention decisions
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Few patients who received elective coronary artery stenting were presented with options to seriously consider, whereas most prostate cancer surgery patients were presented with at least one alternative to surgery, according to results of a survey-based study.
Study participants included fee-for-service Medicare beneficiaries who had surgery for either prostate cancer or elective coronary artery stenting in the last half of 2008. A mail survey was conducted of probability samples of these patients. Surveys were received from 685 eligible participants who had prostate surgery. Of the eligible participants who had a stent procedure, 472 were included in this analysis. Participants reported on which options were presented for serious consideration, the amount of discussion of the pros and cons of the chosen option, and whether they were asked about their preferences.
At least one alternative to surgery was presented as a serious option, 64% of prostate cancer surgery patients reported on the survey. Nearly all (94%) prostate cancer surgery patients said they discussed the pros of the surgery with their doctors, and 63% discussed the cons “a lot” or “some.” Also, 76% had been asked about their treatment preferences. In the group that received stents, only 10% were presented with options to seriously consider. Most (77%) patients talked “a lot” or “some” with their doctors about the reasons for stents, and 19% talked with their doctors about the cons of receiving a stent. Sixteen percent of the group that received stents said they were asked about their treatment preferences.
“While prostate cancer surgery patients reported more involvement in decision-making than elective stent patients, the reports of both groups document the need for increased efforts to inform and involve patients facing preference-sensitive intervention decisions,” the researchers said.
Disclosure: Research was supported by the National Institutes on Aging. See the study for a full list of disclosures.
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