Page 10 - CUA2019 Abstracts - Miscellaneous/Other

Poster session 8: Community Urology and Management

colleague (22%) or a patient (22%). Most respondents were married (65%) MP-8.5
or in a relationship (19%), and 76% of women had at least one child. Patient-centred reconstruction and evaluation of the Canadian
The mean time for maternity leave was 15 weeks and 33% reported a Urological Association’s prostate cancer information materials
pregnancy-related complication triggered by their work (pre-eclampsia, Alexander E. Kiciak , Thomas Dymond , Andrew Dawson , Michael J.
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miscarriage, hypertension, and premature contractions). Most women Leveridge , D. Robert Siemens , Jason P. Izard 1
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(83%) were very satisfied with their family life. However, 74% felt their 1 Urology, Queen’s University, Kingston, ON, Canada
career had compromised their personal life and family responsibilities. Funded by a research grant from the Canadian Urological Association
Increasing female presence in leadership roles, providing mentorship Scholarship Foundation
opportunities, and improving negotiation strategies were areas women Introduction: The Canadian Urological Association (CUA) publishes freely
felt needed more attention. Overall, 64% of women surveyed would accessible patient information materials (PIM) on a range of urological
choose urology again. issues, including prostate cancer. Previous work has established that the
Conclusions: It is important to advocate for the wellness of our current prostate cancer PIM are written at a grade 11 reading level, which may
female urologists and to attract and maintain the most talented physi- be too complex for low-literacy patients. We sought to directly compare
cians in our field. To accomplish this, we need to address the challenges the standard CUA PIM to a reconstructed patient-centred PIM.
revealed in this survey. A formal circle of support, mentorship, and pro- Methods: PIM covering radical prostatectomy (RP) and radiation therapy
motion within the urology community is important to help achieve these (RT) for prostate cancer were rewritten in a simplified format to a 6th-
goals. grade reading level and published in a graphical format identical to the
original PIM. Patients who had undergone previous treatment for local-
MP-8.4 ized prostate cancer or were on active surveillance were recruited from
Creating patient-centred radiology reports (PACERR) to empower Kingston Health Sciences Centre from May 2017 to September 2018.
patients undergoing prostate magnetic resonance imaging Participants evaluated both “standard” and “patient-centred” formats of
Nathan Perlis , Guan Hee Tan , Antonio Finelli , Amelia Di Meo , Michael both RP and RT topics. PIM formats and topics were randomized in order
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Nesbitt , Odelia Lee , Adam Badzynski , Mike Lovas , Kristin Foster , of presentation. We collected demographic, educational, and disease-
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Joseph Cafazzo , Janet Papadakos , Vasiliki Bakas , Alejandro Berlin , specific details of our participants. Health literacy was assessed using the
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David Wiljer , Sangeet Ghai , Masoom Haider 8 REALM-SF. Semi-structured interviews were used to obtain qualitative
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1 Division of Urology, University Health Network, Toronto, ON, Canada; feedback on all PIM. Participants were asked to score the PIM formats on
2 Healthcare Human Factors, University Health Network, Toronto, ON, a Likert scale with respect to usefulness, comprehension, and preference
Canada; Patient Engagement Innovations, University Health Network, of one format over the other.
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Toronto, ON, Canada; Centre for Global eHealth Innovations, Toronto, Results: There were 61 participants with complete information for analy-
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ON, Canada; Patient Education, Cancer Care Ontario, Toronto, ON, sis. The median age of our participants was 70 years (range 50–86), with
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Canada; myUHN Patient Portal, University Health Network, Toronto, ON, a median REALM-SF score of 7 (5–7) and 62% (38/61) had at least some
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Canada; Education Technology and Innovation, Education Technology college or university education. Patients had been treated with surgery
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and Innovation, Toronto, ON, Canada; Joint Department of Medical (35/61), radiation (24/61), and active surveillance (18/61). Usefulness rat-
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Imaging, University Health Network, Toronto, ON, Canada ings were high for all PIM format but did not vary statistically between
Introduction: As we progress to an era when patient autonomy and shared formats (p=0.84). Comprehension ratings were significantly higher in the
decision-making are highly valued, we feel that there is a need to also patient-centred PIM (p<0.01). Preference for PIM format did not reach sta-
have effective patient-centred communication tools. Radiology reports tistical significance (p=0.32 for RP; p=0.19 for RT). However, within the
can be very technical and difficult for our patients to understand, and yet qualitative feedback, 16% of patients commented without prompting that
patients are often expected to make potentially life-changing decisions the language within the standard PIM was too complex. Participants also
based on these reports. Therefore, we aimed to create a patient-centred expressed the desire for more information regarding care after treatment.
prostate magnetic resonance imaging (MRI) report in order to give our Conclusions: Within this group of highly educated participants with high
patients a better understanding of their clinical condition. health literacy, a simplified written structure improves patient comprehen-
Methods: A prototype patient-centred radiology report (PACERR) was sion ratings of informational materials but does not impact participant
created by identifying items to include based on opinions sought from preferences for specific PIM format. Future work will focus on revising
a group of patients undergoing prostate MRI and medical experts using the informational content of our PIM in an iterative format based on
modified Delphi approach in semi-structured interviews. After informed participant feedback.
consent, patients were interviewed based on a salient belief question
in person prior to their MRI. A prototype PACERR was created in col- MP-8.6
laboration with human factors engineering and design, medical imaging, Potential for cost-savings through urological medication
biomedical informatics, and cancer patient education groups. prescribing habits in Ontario
Results: Fifteen patients and eight experts from urology, radiation oncol- Patrick Anderson , Christopher Langley , Neal E. Rowe 1,2
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ogy, radiology, and nursing participated in this study. Patients were particu- 1 Department of Surgery, Division of Urology, The Ottawa Hospital,
larly interested to have a report with laymen terms, concise language, con- Ottawa, ON, Canada; University of Ottawa, Ottawa, ON, Canada
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textualization of values, defining medical terms, and next course of action. Introduction: North Americans pay the highest drug prices in the world.
The experts placed importance on getting across how severe the condition Funding for prescription medications is provided either by government,
is, Prostate Imaging Reporting and Data System (PI-RADS) score and the private insurance, or directly out-of-pocket. With limited resources, there
context for it in laymen terms, and the course of action. Everyone felt is a responsibility for all physicians to consider medication costs as part
the report should include the risk of MRI findings actually being cancer of their role as managers. Significant differences in the cumulative costs
in the subsequent biopsy and whether the images showed extra-prostatic of medical treatment between name brand and generic drugs can occur
disease. A prototype PACERR was created as shown in Fig. 1. over time, as well as large cost differences between equally efficacious
Conclusions: A prostate MRI PACERR has been developed to communi- therapies. Here, we present a cost analysis of common medications in
cate the most important findings relevant to decision-making in prostate urology practice as an illustration of potential cost-savings.
cancer. The ability of this tool to improve patient knowledge and com- Methods: The Ontario Drug Benefit/Comparative Drug Index Formulary
munication will be explored. was used to determine the costs associated with prescription formulations
This paper has a figure, which may be viewed online at: commonly used in urology practice. Benign prostatic hyperplasia (BPH)
https://2019.cua.events/webapp/lecture/197 and castration-sensitive metastatic prostate cancer were selected as index
diseases due to relative commonality and prolonged duration of medical
treatment. The cumulative cost of treatment with brand name and generic
CUAJ • June 2019 • Volume 13, Issue 6(Suppl5) S137