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Quality of care received and patient-reported regret in prostate cancer: Analysis of a population-based prospective cohort.

Abstract：

BACKGROUND:Meeting quality of care standards in oncology is recognized as important by physicians, professional organizations, and payers. Data from a population-based cohort of patients with prostate cancer were used to examine whether receipt of care was consistent with published consensus metrics and whether receiving high-quality care was associated with less patient-reported treatment decisional regret. METHODS:Patients with incident prostate cancer were enrolled in collaboration with the North Carolina Central Cancer Registry, with an oversampling of minority patients. Medical record abstraction was used to determine whether participants received high-quality care based on 5 standards: 1) discussion of all treatment options; 2) complete workup (prostate-specific antigen, Gleason grade, and clinical stage); 3) low-risk participants did not undergo a bone scan; 4) high-risk participants treated with radiotherapy (RT) received androgen deprivation therapy; and 5) participants treated with RT received conformal or intensity-modulated RT. Treatment decisional regret was assessed using a validated instrument. RESULTS:A total of 804 participants were analyzed. Overall, 66% of African American and 73% of white participants received care that met all standards (P = .03); this racial difference was confirmed by multivariable analysis. Care that included "discussion of all treatment options" was found to be associated with less patient-reported regret on univariable analysis (P = .03) and multivariable analysis (odds ratio, 0.59; 95% confidence interval, 0.37-0.95). CONCLUSIONS:The majority of participants received high-quality care, but racial disparity existed. Participants who discussed all treatment options appeared to have less treatment decisional regret. To the authors' knowledge, this is the first study to demonstrate an association between a quality of care metric and patient-reported outcome. Cancer 2017;138-143. © 2016 American Cancer Society.

journal_name

Cancer

journal_title

Cancer

authors

Holmes JA,Bensen JT,Mohler JL,Song L,Mishel MH,Chen RC

doi

10.1002/cncr.30315

subject

Has Abstract

pub_date

2017-01-01 00:00:00

pages

138-143

issue

eissn

0008-543X

issn

1097-0142

journal_volume

123

pub_type

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Quality of care received and patient-reported regret in prostate cancer: Analysis of a population-based prospective cohort.