Pd32-03 association between trust, outcomes and racial disparity in prostate cancer care

You have accessJournal of UrologyCME1 Apr 2023PD32-03 ASSOCIATION BETWEEN TRUST, OUTCOMES AND RACIAL DISPARITY IN PROSTATE CANCER CARE Sumedha Chhatre, Joseph Gallo, Thomas Guzzo, Knashawn Morales, Neha Vapiwala, Keith Van Arsdalen, Alan Wein, S Bruce Malkowicz, and Ravishankar Jayadevappa Sumedha ChhatreSumedha Chhatre More articles by this author , Joseph GalloJoseph Gallo More articles by this author , Thomas GuzzoThomas Guzzo More articles by this author , Knashawn MoralesKnashawn Morales More articles by this author , Neha VapiwalaNeha Vapiwala More articles by this author , Keith Van ArsdalenKeith Van Arsdalen More articles by this author , Alan WeinAlan Wein More articles by this author , S Bruce MalkowiczS Bruce Malkowicz More articles by this author , and Ravishankar JayadevappaRavishankar Jayadevappa More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003325.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Trust is an important aspect of healthcare and of the patient-physician relationship. Differences in levels of trust among patients may help explain variations in care seeking and use of medical services. However, these associations remain understudied. Objective is to study the association between patient-physician trust and treatment choice and outcomes among low, intermediate and high-risk, White and African American prostate cancer patients. METHODS: We used data from a multi-centered randomized controlled study among localized prostate cancer patients. Trust was measured at baseline using Patient Trust - Wake Forest Physician Trust Scale (PTWF). Outcomes were assessed at baseline, and at 3, 6, 12 and 24-month follow-up. Treatments were robotic-assisted laparoscopic radical prostatectomy, radiation therapy and active surveillance. Participants were categorized into risk groups as: low risk (PSA <10 ng/ml, Gleason ≤6, clinical stage T1-2a), intermediate risk (PSA 10 -20 ng/ml, Gleason 7, clinical stage T2b), and high risk was (PSA >20, Gleason ≥8, clinical stage T2c-3a). Association between treatment type, and trust (PTWF score) and race for each risk category was assessed using multinomial logistic models. RESULTS: Of the 743 localized prostate cancer patients recruited for the study, 82% were White and 14% were African American. Retention rate was >75% during follow-up. Proportion of risk categories was: 34% low-risk, 32% intermediate-risk and 34% high-risk. Baseline trust was comparable between White and African American patients (mean=19.5, standard deviation (std)=6.1 vs. mean=20.5, std=6.8, p=0.8032). Also, baseline trust was comparable between intervention group and usual care group (mean=19.3, std=6.0 vs mean=19.8, std=6.4; p=0.397). Results of multinomial regression indicated that trust and race were not associated with treatment choice independently. CONCLUSIONS: This is one of the largest study that has assessed the relationship between trust, race and outcomes in localized prostate cancer patients. We observed that baseline trust was comparable between White and African American patients. Also, neither trust, not race was associated with treatment choice and outcomes. Thus, other factors such as patient-centered preference assessment, may be associated with treatment choice in prostate cancer patients. Source of Funding: PCORI CE-12-11-4973 © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e908 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sumedha Chhatre More articles by this author Joseph Gallo More articles by this author Thomas Guzzo More articles by this author Knashawn Morales More articles by this author Neha Vapiwala More articles by this author Keith Van Arsdalen More articles by this author Alan Wein More articles by this author S Bruce Malkowicz More articles by this author Ravishankar Jayadevappa More articles by this author Expand All Advertisement PDF downloadLoading ...