ArticleImplementation science : IS2018
De-implementation of low value castration for men with prostate cancer: protocol for a theory-based, mixed methods approach to minimizing low value androgen deprivation therapy (DeADT).
Article in Implementation science : IS, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03579680 (De-implementation of Low Value Castration for Men With Prostate Cancer), which is not on this map. Cited by 9 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
De-implementation of Low Value Castration for Men With Prostate Cancer
Who cites it
9 citing papers in PubMed.
- Barriers and Facilitators of Treatment Intensification in Metastatic Castration-Sensitive Prostate Cancer.JAMA network open · 2025Article
- Reducing the frequency of hand hygiene to maintain skin integrity among nurses in the growing care unit: A pilot study.Fujita medical journal · 2025Article
- Unpacking overuse of androgen deprivation therapy for prostate cancer to inform de-implementation strategies.Implementation science communications · 2024Article
- Creation of a theoretically rooted workbook to support implementers in the practice of knowledge translation.Implementation science communications · 2023Article
- Applying the behavior change wheel to design de-implementation strategies to reduce low-value statin prescription in primary prevention of cardiovascular disease in primary care.Frontiers in medicine · 2022Article
- A scoping review of de-implementation frameworks and models.Implementation science : IS · 2021Article
- Learning from the "tail end" of de-implementation: the case of chemical castration for localized prostate cancer.Implementation science communications · 2021Article
- De-implementation and substitution of clinical care processes: stakeholder perspectives on the transition to primary human papillomavirus (HPV) testing for cervical cancer screening.Implementation science communications · 2021Article
- Use of the theoretical domains framework and behaviour change wheel to develop a novel intervention to improve the quality of multidisciplinary cancer conference decision-making.BMC health services research · 2020Article
Corrections and comments
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Authors and funding
15 authors.
Funding
Abstract
backgroundMen with prostate cancer are often castrated with long-acting injectable drugs termed androgen deprivation therapy (ADT). Although many benefit, ADT is also used in patients with little or nothing to gain. The best ways to stop this practice are unknown, and range from blunt pharmacy restrictions to informed decision-making. This study will refine and pilot two different de-implementation strategies for reducing ADT use among those unlikely to benefit in preparation for a comparative effectiveness trial. METHODS/
designThis innovative mixed methods research program has three aims. Aim 1: To assess preferences and barriers for de-implementation of chemical castration in prostate cancer. Guided by the theoretical domains framework (TDF), urologists and patients from facilities with the highest and lowest castration rates across the VA will be interviewed to identify key preferences and de-implementation barriers for reducing castration as prostate cancer treatment. This qualitative work will inform Aim 2 while gathering rich information for two proposed pilot intervention strategies. Aim 2: To use a discrete choice experiment (DCE), a novel barrier prioritization approach, for de-implementation strategy tailoring. The investigators will conduct national surveys of urologists to prioritize key barriers identified in Aim 1 for stopping incident castration as localized prostate cancer treatment using a DCE experiment design. These quantitative results will identify the most important barriers to be addressed through tailoring of two pilot de-implementation strategies in preparation for Aim 3 piloting. Aim 3: To pilot two tailored de-implementation strategies to reduce castration as localized prostate cancer treatment. Building on findings from Aims 1 and 2, two de-implementation strategies will be piloted. One strategy will focus on formulary restriction at the organizational level and the other on physician/patient informed decision-making at different facilities. Outcomes will include acceptability, feasibility, and scalability in preparation for an effectiveness trial comparing these two widely varying de-implementation strategies. DISCUSSION: Our innovative approach to de-implementation strategy development is directly aligned with state-of-the-art complex implementation intervention development and implementation science. This work will broadly advance de-implementation science for low value cancer care, and foster participation in our de-implementation evaluation trial by addressing barriers, facilitators, and concerns through pilot tailoring.
trial registrationClinicalTrials.gov Identifier: NCT03579680 , First Posted July 6, 2018.
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