Patients Can Administer Mobile Audio Recordings to Increase Knowledge in Advanced Prostate Cancer

ABSTRACT Introduction Consultation audio recordings improve patient decision‐making but are underutilized. Patient‐administered recording apps on mobile devices may increase access, but implementation has not been evaluated. Methods We conducted a single‐arm study delivering education, coaching, and...

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Main Authors: Daniel H. Kwon, Lauren Trihy, Nika Darvish, Eliza Hearst, Saffanat Sumra, Hala T. Borno, Rohit Bose, Jonathan Chou, Ivan deKouchkovsky, Arpita Desai, Brad Ekstrand, Terence Friedlander, Gurleen Kaur, Vadim S. Koshkin, Samantha Nesheiwat, Karen Sepucha, Eric J. Small, Rahul R. Aggarwal, Jeffrey Belkora
Format: Article
Language:English
Published: Wiley 2024-11-01
Series:Cancer Medicine
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Online Access:https://doi.org/10.1002/cam4.70433
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author Daniel H. Kwon
Lauren Trihy
Nika Darvish
Eliza Hearst
Saffanat Sumra
Hala T. Borno
Rohit Bose
Jonathan Chou
Ivan deKouchkovsky
Arpita Desai
Brad Ekstrand
Terence Friedlander
Gurleen Kaur
Vadim S. Koshkin
Samantha Nesheiwat
Karen Sepucha
Eric J. Small
Rahul R. Aggarwal
Jeffrey Belkora
author_facet Daniel H. Kwon
Lauren Trihy
Nika Darvish
Eliza Hearst
Saffanat Sumra
Hala T. Borno
Rohit Bose
Jonathan Chou
Ivan deKouchkovsky
Arpita Desai
Brad Ekstrand
Terence Friedlander
Gurleen Kaur
Vadim S. Koshkin
Samantha Nesheiwat
Karen Sepucha
Eric J. Small
Rahul R. Aggarwal
Jeffrey Belkora
author_sort Daniel H. Kwon
collection DOAJ
description ABSTRACT Introduction Consultation audio recordings improve patient decision‐making but are underutilized. Patient‐administered recording apps on mobile devices may increase access, but implementation has not been evaluated. Methods We conducted a single‐arm study delivering education, coaching, and reminders for patients to record their appointment using a mobile recording app. Patients had progressive, advanced prostate cancer and an upcoming appointment where the option of docetaxel would be discussed. We used the RE‐AIM framework for evaluation. Reach was the proportion of patients who participated. Effectiveness was change in informed decision‐making pre‐ vs. post‐appointment. We used a questionnaire evaluating patient knowledge about docetaxel (0%–100% correct) and the decisional conflict scale‐informed subscale (0 = feels extremely uninformed to 100 = extremely informed) to compare means using the paired t‐test. Adoption was the proportion of providers agreeing to be recorded. Implementation was coordinator adherence to intervention delivery. We conducted semistructured interviews with patients, caregivers, and providers to assess barriers, facilitators, and suggestions for recording implementation. Results Of 102 patients approached, 50 (49%) patients participated. Mean age was 75 years, 38 (76%) were Non‐Hispanic White, and 43 (86%) had telehealth appointments. Knowledge increased from 44.7% to 49.5% (p = 0.019), particularly about palliative care (42% answering correctly to 60%, p = 0.035). Decisional conflict‐informed subscale increased from 48.9 to 70.9 (p < 0.001). Forty‐three patients (85%) made a recording, of whom 33 (77%) reported the recording helped treatment decision‐making. All 17 providers agreed to be recorded. Coordinator adherence was high. Multi‐level barriers, suggestions, and facilitators mostly related to intervention complexity and stakeholder compatibility. Conclusion Patient‐administered audio recordings had a positive effect on decision‐making, particularly for palliative care awareness. For broader implementation, efforts should focus on revising institutional policies; teaching patients or caregivers to use existing recording functions on their devices; leveraging artificial intelligence for transcription and summarization; and integrating recording into telehealth technology and electronic patient portals. Trial Registration: https://clinicaltrials.gov/study/NCT05127850
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spelling doaj-art-0d02c450ed2a4fcf8034fd1bda9396bd2024-12-16T05:15:42ZengWileyCancer Medicine2045-76342024-11-011322n/an/a10.1002/cam4.70433Patients Can Administer Mobile Audio Recordings to Increase Knowledge in Advanced Prostate CancerDaniel H. Kwon0Lauren Trihy1Nika Darvish2Eliza Hearst3Saffanat Sumra4Hala T. Borno5Rohit Bose6Jonathan Chou7Ivan deKouchkovsky8Arpita Desai9Brad Ekstrand10Terence Friedlander11Gurleen Kaur12Vadim S. Koshkin13Samantha Nesheiwat14Karen Sepucha15Eric J. Small16Rahul R. Aggarwal17Jeffrey Belkora18Division of Hematology/Oncology, Department of Medicine University of California San Francisco California USAHelen Diller Family Comprehensive Cancer Center University of California San Francisco California USADepartment of Surgery University of California San Francisco California USADepartment of Surgery University of California San Francisco California USADepartment of Surgery University of California San Francisco California USADivision of Hematology/Oncology, Department of Medicine University of California San Francisco California USADivision of Hematology/Oncology, Department of Medicine University of California San Francisco California USADivision of Hematology/Oncology, Department of Medicine University of California San Francisco California USADivision of Hematology/Oncology, Department of Medicine University of California San Francisco California USADivision of Hematology/Oncology, Department of Medicine University of California San Francisco California USAHelen Diller Family Comprehensive Cancer Center University of California San Francisco California USADivision of Hematology/Oncology, Department of Medicine University of California San Francisco California USADepartment of Surgery University of California San Francisco California USADivision of Hematology/Oncology, Department of Medicine University of California San Francisco California USADepartment of Surgery University of California San Francisco California USAHarvard Medical School Boston Massachusetts USADivision of Hematology/Oncology, Department of Medicine University of California San Francisco California USADivision of Hematology/Oncology, Department of Medicine University of California San Francisco California USADepartment of Surgery University of California San Francisco California USAABSTRACT Introduction Consultation audio recordings improve patient decision‐making but are underutilized. Patient‐administered recording apps on mobile devices may increase access, but implementation has not been evaluated. Methods We conducted a single‐arm study delivering education, coaching, and reminders for patients to record their appointment using a mobile recording app. Patients had progressive, advanced prostate cancer and an upcoming appointment where the option of docetaxel would be discussed. We used the RE‐AIM framework for evaluation. Reach was the proportion of patients who participated. Effectiveness was change in informed decision‐making pre‐ vs. post‐appointment. We used a questionnaire evaluating patient knowledge about docetaxel (0%–100% correct) and the decisional conflict scale‐informed subscale (0 = feels extremely uninformed to 100 = extremely informed) to compare means using the paired t‐test. Adoption was the proportion of providers agreeing to be recorded. Implementation was coordinator adherence to intervention delivery. We conducted semistructured interviews with patients, caregivers, and providers to assess barriers, facilitators, and suggestions for recording implementation. Results Of 102 patients approached, 50 (49%) patients participated. Mean age was 75 years, 38 (76%) were Non‐Hispanic White, and 43 (86%) had telehealth appointments. Knowledge increased from 44.7% to 49.5% (p = 0.019), particularly about palliative care (42% answering correctly to 60%, p = 0.035). Decisional conflict‐informed subscale increased from 48.9 to 70.9 (p < 0.001). Forty‐three patients (85%) made a recording, of whom 33 (77%) reported the recording helped treatment decision‐making. All 17 providers agreed to be recorded. Coordinator adherence was high. Multi‐level barriers, suggestions, and facilitators mostly related to intervention complexity and stakeholder compatibility. Conclusion Patient‐administered audio recordings had a positive effect on decision‐making, particularly for palliative care awareness. For broader implementation, efforts should focus on revising institutional policies; teaching patients or caregivers to use existing recording functions on their devices; leveraging artificial intelligence for transcription and summarization; and integrating recording into telehealth technology and electronic patient portals. Trial Registration: https://clinicaltrials.gov/study/NCT05127850https://doi.org/10.1002/cam4.70433implementation sciencepalliative carepatient educationpatient knowledgeprostate cancerrecordings
spellingShingle Daniel H. Kwon
Lauren Trihy
Nika Darvish
Eliza Hearst
Saffanat Sumra
Hala T. Borno
Rohit Bose
Jonathan Chou
Ivan deKouchkovsky
Arpita Desai
Brad Ekstrand
Terence Friedlander
Gurleen Kaur
Vadim S. Koshkin
Samantha Nesheiwat
Karen Sepucha
Eric J. Small
Rahul R. Aggarwal
Jeffrey Belkora
Patients Can Administer Mobile Audio Recordings to Increase Knowledge in Advanced Prostate Cancer
Cancer Medicine
implementation science
palliative care
patient education
patient knowledge
prostate cancer
recordings
title Patients Can Administer Mobile Audio Recordings to Increase Knowledge in Advanced Prostate Cancer
title_full Patients Can Administer Mobile Audio Recordings to Increase Knowledge in Advanced Prostate Cancer
title_fullStr Patients Can Administer Mobile Audio Recordings to Increase Knowledge in Advanced Prostate Cancer
title_full_unstemmed Patients Can Administer Mobile Audio Recordings to Increase Knowledge in Advanced Prostate Cancer
title_short Patients Can Administer Mobile Audio Recordings to Increase Knowledge in Advanced Prostate Cancer
title_sort patients can administer mobile audio recordings to increase knowledge in advanced prostate cancer
topic implementation science
palliative care
patient education
patient knowledge
prostate cancer
recordings
url https://doi.org/10.1002/cam4.70433
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