Limits...
What do urologists think patients need to know when starting on androgen deprivation therapy? The perspective from Canada versus countries with lower gross domestic product.

Rot I, Wassersug RJ, Walker LM - Transl Androl Urol (2016)

Bottom Line: No differences were found between responses from Canadian urologists and high GDP countries.Infertility was the only side effect more often disclosed by urologists in low GDP counties.Factors that could contribute to differences include economics (e.g., ADT drug costs), differences in side effect presentation due to different ADT drugs used, racial differences in perceived side effect burden, disease status at ADT commencement, and cultural differences in patient-physician shared-decision making.

View Article: PubMed Central - PubMed

Affiliation: 1 Department of Medical Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada ; 2 Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada ; 3 Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Victoria, Australia ; 4 Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Alberta, Canada.

ABSTRACT

Background: Androgen deprivation therapy (ADT) side effects are numerous and negatively impact prostate cancer patients' quality of life. There is considerable discrepancy though among Canadian urologists regarding what ADT side effects and side effect management strategies. Little is known about global differences in ADT patient education.

Methods: International respondents were recruited via online posting and at an international urology conference. Hypotheses suggest that economic and cultural differences influence patient education practices; therefore, international respondents were divided into 3 categories (high, medium, and low gross domestic product).

Results: No differences were found between responses from Canadian urologists and high GDP countries. Compared to responses from low GDP countries, Canadian urologists are more likely to endorse informing patients about: osteoporosis, loss of muscle mass, weight gain, fatigue/sleep disturbance, relationship changes, cognitive changes, and loss of body hair. Infertility was the only side effect more often disclosed by urologists in low GDP counties. Recommended management strategies for hot flashes are more likely to be pharmaceutical in Canada, and behavioral in low GDP countries. Management strategies for gynecomastia are emphasized more in low GDP countries. Physical exercise is endorsed consistently more often by Canadian urologists.

Conclusions: ADT educational practices vary greatly between Canada and lower GDP countries. Factors that could contribute to differences include economics (e.g., ADT drug costs), differences in side effect presentation due to different ADT drugs used, racial differences in perceived side effect burden, disease status at ADT commencement, and cultural differences in patient-physician shared-decision making.

No MeSH data available.


Related in: MedlinePlus

Comparison of strategies recommended for managing side effects of ADT between Canadian urologists and urologists from lower GDP countries. Only side effects for which there was a significant differences at P<0.01 in recommended management strategies between the two groups of urologists are presented. The strategies are arranged left to right in order from those that Canadian urologists endorse most to least often. Strategies endorsed always or often are above zero on the x-axis and those endorsed sometimes/rarely or never are below zero. The biggest differences between the two populations are in management strategies recommended for gynecomastia, followed by hot flashes and osteoporosis.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4837317&req=5

f2: Comparison of strategies recommended for managing side effects of ADT between Canadian urologists and urologists from lower GDP countries. Only side effects for which there was a significant differences at P<0.01 in recommended management strategies between the two groups of urologists are presented. The strategies are arranged left to right in order from those that Canadian urologists endorse most to least often. Strategies endorsed always or often are above zero on the x-axis and those endorsed sometimes/rarely or never are below zero. The biggest differences between the two populations are in management strategies recommended for gynecomastia, followed by hot flashes and osteoporosis.

Mentions: Table 3 and Figure 2 show ADT side effect management strategies in which significant differences in endorsement were found between urologists in Canada and urologists in lower GDP countries. Seven side effects had one or more management strategies that differed significantly between Canada and lower GDP countries (Figure 2).


What do urologists think patients need to know when starting on androgen deprivation therapy? The perspective from Canada versus countries with lower gross domestic product.

Rot I, Wassersug RJ, Walker LM - Transl Androl Urol (2016)

Comparison of strategies recommended for managing side effects of ADT between Canadian urologists and urologists from lower GDP countries. Only side effects for which there was a significant differences at P<0.01 in recommended management strategies between the two groups of urologists are presented. The strategies are arranged left to right in order from those that Canadian urologists endorse most to least often. Strategies endorsed always or often are above zero on the x-axis and those endorsed sometimes/rarely or never are below zero. The biggest differences between the two populations are in management strategies recommended for gynecomastia, followed by hot flashes and osteoporosis.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4837317&req=5

f2: Comparison of strategies recommended for managing side effects of ADT between Canadian urologists and urologists from lower GDP countries. Only side effects for which there was a significant differences at P<0.01 in recommended management strategies between the two groups of urologists are presented. The strategies are arranged left to right in order from those that Canadian urologists endorse most to least often. Strategies endorsed always or often are above zero on the x-axis and those endorsed sometimes/rarely or never are below zero. The biggest differences between the two populations are in management strategies recommended for gynecomastia, followed by hot flashes and osteoporosis.
Mentions: Table 3 and Figure 2 show ADT side effect management strategies in which significant differences in endorsement were found between urologists in Canada and urologists in lower GDP countries. Seven side effects had one or more management strategies that differed significantly between Canada and lower GDP countries (Figure 2).

Bottom Line: No differences were found between responses from Canadian urologists and high GDP countries.Infertility was the only side effect more often disclosed by urologists in low GDP counties.Factors that could contribute to differences include economics (e.g., ADT drug costs), differences in side effect presentation due to different ADT drugs used, racial differences in perceived side effect burden, disease status at ADT commencement, and cultural differences in patient-physician shared-decision making.

View Article: PubMed Central - PubMed

Affiliation: 1 Department of Medical Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada ; 2 Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada ; 3 Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Victoria, Australia ; 4 Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Alberta, Canada.

ABSTRACT

Background: Androgen deprivation therapy (ADT) side effects are numerous and negatively impact prostate cancer patients' quality of life. There is considerable discrepancy though among Canadian urologists regarding what ADT side effects and side effect management strategies. Little is known about global differences in ADT patient education.

Methods: International respondents were recruited via online posting and at an international urology conference. Hypotheses suggest that economic and cultural differences influence patient education practices; therefore, international respondents were divided into 3 categories (high, medium, and low gross domestic product).

Results: No differences were found between responses from Canadian urologists and high GDP countries. Compared to responses from low GDP countries, Canadian urologists are more likely to endorse informing patients about: osteoporosis, loss of muscle mass, weight gain, fatigue/sleep disturbance, relationship changes, cognitive changes, and loss of body hair. Infertility was the only side effect more often disclosed by urologists in low GDP counties. Recommended management strategies for hot flashes are more likely to be pharmaceutical in Canada, and behavioral in low GDP countries. Management strategies for gynecomastia are emphasized more in low GDP countries. Physical exercise is endorsed consistently more often by Canadian urologists.

Conclusions: ADT educational practices vary greatly between Canada and lower GDP countries. Factors that could contribute to differences include economics (e.g., ADT drug costs), differences in side effect presentation due to different ADT drugs used, racial differences in perceived side effect burden, disease status at ADT commencement, and cultural differences in patient-physician shared-decision making.

No MeSH data available.


Related in: MedlinePlus