A Pragmatic Trial of the Effect of a Mailed Patient Flyer About Prostate Specific Antigen (PSA) Testing Prior to an Annual Exam

Study Overview
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Brief Summary
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Does a one-page American College of Physicians educational flyer about the pros and cons of prostate cancer screening sent to men within two weeks of their scheduled annual health examinations in a general medicine clinic result in a different rate of prostate cancer screening than among men who were not sent the flyer? Do patients find the flyer useful and understandable? Context: The use of prostate specific antigen (PSA) screening for prostate cancer is controversial because of a lack of evidence that such screening saves lives when applied within a population and because such testing can lead to invasive downstream biopsies and aggressive treatment that is associated with a high risk of permanent side effects (e.g. impotence, incontinence). Almost all professional societies (American Cancer Society, American Urologic Association, American College of Physicians, United States Preventive Services Task Force) advocate that patients receive education and complete an informed decision-making discussion with their medical providers about the pros and cons of the PSA test, as well as their personal preferences, before proceeding with this test. Unfortunately, despite these recommendations, there is seldom sufficient time during clinic visits to achieve this goal.

Official Title
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A Pragmatic Randomized Trial of the Effect of a Mailed Patient Flyer About PSA Testing Prior to an Annual Exam

Conditions
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Prostate Cancer Screening

Intervention / Treatment
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* Other: PSA flyer


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Men age 50-74 who were cared for in a general internal medicine clinic had scheduled an annual health exam had not had a PSA test within the previous year Exclusion Criteria: active cancer diagnosis history of prostate cancer need for PSA surveillance

Ages Eligible for Study
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Minimum Age: 50 Years
Maximum Age: 74 Years

Sexes Eligible for Study
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Male

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Screening
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: PSA flyer<br> | Other: PSA flyer<br>* A mailed low-literacy informational patient flyer about the PSA test<br>|
| No Intervention: Control<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Rate of PSA testing | Rate of PSA testing will be determined by reviewing the chart of enrolled patients within two weeks of their annual physical | At the time of the annual exam (within two weeks of their annual physical) | 
| Rate of documented PSA discussions | Rate of documented PSA discussions will be determined through chart review within two weeks of the annual physical. | At the time of the annual exam (within two weeks of their annual physical) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Flyer acceptability | The acceptability of the flyer will be assessed through a follow-up phone interview of patients who had received the flyer. | Within two weeks of the annual exam | 
| Perceived participation | Perceived participation will be assessed in a follow-up phone interview within two weeks of the annual physical using validated measures of particiption in decision making. | Within two weeks | 
| Prostate Cancer Screening knowledge | Prostate cancer screening knowledge will be assessed using 5 knowledge questions surrounding PSA testing during a follow-up interview 2 weeks after the annual physical | Within two weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Prostate Cancer Screening, Pragmatic Trial, Health Literacy