The association between patients' preferred treatment after the use of a patient decision aid and their choice of eventual treatment
Abstract Objective To investigate the association between patients' preferred treatment and eventual treatment. Second, to compare patients with surgical treatment to watchful waiting in order to identify predictive factors for surgery. Methods A single‐centre retrospective study was performed...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2020-06-01
|
| Series: | Health Expectations |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/hex.13045 |
| _version_ | 1828390887517847552 |
|---|---|
| author | Carmen S. S. Latenstein Floris M. Thunnissen Bastiaan J. M. Thomeer Bob J. vanWely Marjan J. Meinders Glyn Elwyn Philip R. deReuver |
| author_facet | Carmen S. S. Latenstein Floris M. Thunnissen Bastiaan J. M. Thomeer Bob J. vanWely Marjan J. Meinders Glyn Elwyn Philip R. deReuver |
| author_sort | Carmen S. S. Latenstein |
| collection | DOAJ |
| description | Abstract Objective To investigate the association between patients' preferred treatment and eventual treatment. Second, to compare patients with surgical treatment to watchful waiting in order to identify predictive factors for surgery. Methods A single‐centre retrospective study was performed between December 2015 and August 2018. Patients (≥18 years) who used a patient decision aid (PDA) for gallstones or inguinal hernia were included. After their first surgical consultation, patients received access to an online PDA. The patients' preferred treatment after the PDA was compared with their choice of eventual treatment. Multivariable regression analyses were performed for predictive factors for surgery. Results In total, 567 patients with gallstones and 585 patients with an inguinal hernia were included. Of the patients with gallstones, 121 (21%) preferred watchful waiting, 367 (65%) preferred surgery, and 79 (14%) were not sure. The patients' preferred treatment was performed in 85.9%. Frequent pain attacks (OR 2.1, 95% CI 1.1‐3.9, P = .020) and preference for surgery (OR 4.4, 95% CI 1.9‐10.1, P = .001) independently predicted surgery. Of the patients with an inguinal hernia, 77 (13.2%) preferred watchful waiting, 452 (78.8%) preferred surgery, and 56 (9.6%) were not sure. The patients' preferred treatment was performed in 86.0%. The preference for surgery (OR 5.2, 95% CI 2.5‐10.6, P < .001) independently predicted surgery and worry about complications predicted avoidance of surgery (OR 0.5, 95% CI 0.2‐1.0, P = .037). Conclusion This study, reflecting current clinical care, shows that patients' preferred treatment after using a PDA matches their eventual treatment choice in 86% of patients with gallstones or an inguinal hernia. In these patients, symptoms and patients' preference for surgery independently predicts eventual choice of surgery. |
| first_indexed | 2024-12-10T06:53:29Z |
| format | Article |
| id | doaj.art-1a499165b0ce42faa9ff8f5b52e085ad |
| institution | Directory Open Access Journal |
| issn | 1369-6513 1369-7625 |
| language | English |
| last_indexed | 2024-12-10T06:53:29Z |
| publishDate | 2020-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Health Expectations |
| spelling | doaj.art-1a499165b0ce42faa9ff8f5b52e085ad2022-12-22T01:58:29ZengWileyHealth Expectations1369-65131369-76252020-06-0123365165810.1111/hex.13045The association between patients' preferred treatment after the use of a patient decision aid and their choice of eventual treatmentCarmen S. S. Latenstein0Floris M. Thunnissen1Bastiaan J. M. Thomeer2Bob J. vanWely3Marjan J. Meinders4Glyn Elwyn5Philip R. deReuver6Department of Surgery Radboud University Medical Center Nijmegen The NetherlandsDepartment of Surgery Radboud University Medical Center Nijmegen The NetherlandsDepartment of Surgery Bernhoven Uden The NetherlandsDepartment of Surgery Bernhoven Uden The NetherlandsScientific Institute for Quality of Healthcare (IQ Healthcare) Radboud University Medical Center Nijmegen The NetherlandsScientific Institute for Quality of Healthcare (IQ Healthcare) Radboud University Medical Center Nijmegen The NetherlandsDepartment of Surgery Radboud University Medical Center Nijmegen The NetherlandsAbstract Objective To investigate the association between patients' preferred treatment and eventual treatment. Second, to compare patients with surgical treatment to watchful waiting in order to identify predictive factors for surgery. Methods A single‐centre retrospective study was performed between December 2015 and August 2018. Patients (≥18 years) who used a patient decision aid (PDA) for gallstones or inguinal hernia were included. After their first surgical consultation, patients received access to an online PDA. The patients' preferred treatment after the PDA was compared with their choice of eventual treatment. Multivariable regression analyses were performed for predictive factors for surgery. Results In total, 567 patients with gallstones and 585 patients with an inguinal hernia were included. Of the patients with gallstones, 121 (21%) preferred watchful waiting, 367 (65%) preferred surgery, and 79 (14%) were not sure. The patients' preferred treatment was performed in 85.9%. Frequent pain attacks (OR 2.1, 95% CI 1.1‐3.9, P = .020) and preference for surgery (OR 4.4, 95% CI 1.9‐10.1, P = .001) independently predicted surgery. Of the patients with an inguinal hernia, 77 (13.2%) preferred watchful waiting, 452 (78.8%) preferred surgery, and 56 (9.6%) were not sure. The patients' preferred treatment was performed in 86.0%. The preference for surgery (OR 5.2, 95% CI 2.5‐10.6, P < .001) independently predicted surgery and worry about complications predicted avoidance of surgery (OR 0.5, 95% CI 0.2‐1.0, P = .037). Conclusion This study, reflecting current clinical care, shows that patients' preferred treatment after using a PDA matches their eventual treatment choice in 86% of patients with gallstones or an inguinal hernia. In these patients, symptoms and patients' preference for surgery independently predicts eventual choice of surgery.https://doi.org/10.1111/hex.13045general surgerypatient decision aidpatients' preferenceshared decision making |
| spellingShingle | Carmen S. S. Latenstein Floris M. Thunnissen Bastiaan J. M. Thomeer Bob J. vanWely Marjan J. Meinders Glyn Elwyn Philip R. deReuver The association between patients' preferred treatment after the use of a patient decision aid and their choice of eventual treatment Health Expectations general surgery patient decision aid patients' preference shared decision making |
| title | The association between patients' preferred treatment after the use of a patient decision aid and their choice of eventual treatment |
| title_full | The association between patients' preferred treatment after the use of a patient decision aid and their choice of eventual treatment |
| title_fullStr | The association between patients' preferred treatment after the use of a patient decision aid and their choice of eventual treatment |
| title_full_unstemmed | The association between patients' preferred treatment after the use of a patient decision aid and their choice of eventual treatment |
| title_short | The association between patients' preferred treatment after the use of a patient decision aid and their choice of eventual treatment |
| title_sort | association between patients preferred treatment after the use of a patient decision aid and their choice of eventual treatment |
| topic | general surgery patient decision aid patients' preference shared decision making |
| url | https://doi.org/10.1111/hex.13045 |
| work_keys_str_mv | AT carmensslatenstein theassociationbetweenpatientspreferredtreatmentaftertheuseofapatientdecisionaidandtheirchoiceofeventualtreatment AT florismthunnissen theassociationbetweenpatientspreferredtreatmentaftertheuseofapatientdecisionaidandtheirchoiceofeventualtreatment AT bastiaanjmthomeer theassociationbetweenpatientspreferredtreatmentaftertheuseofapatientdecisionaidandtheirchoiceofeventualtreatment AT bobjvanwely theassociationbetweenpatientspreferredtreatmentaftertheuseofapatientdecisionaidandtheirchoiceofeventualtreatment AT marjanjmeinders theassociationbetweenpatientspreferredtreatmentaftertheuseofapatientdecisionaidandtheirchoiceofeventualtreatment AT glynelwyn theassociationbetweenpatientspreferredtreatmentaftertheuseofapatientdecisionaidandtheirchoiceofeventualtreatment AT philiprdereuver theassociationbetweenpatientspreferredtreatmentaftertheuseofapatientdecisionaidandtheirchoiceofeventualtreatment AT carmensslatenstein associationbetweenpatientspreferredtreatmentaftertheuseofapatientdecisionaidandtheirchoiceofeventualtreatment AT florismthunnissen associationbetweenpatientspreferredtreatmentaftertheuseofapatientdecisionaidandtheirchoiceofeventualtreatment AT bastiaanjmthomeer associationbetweenpatientspreferredtreatmentaftertheuseofapatientdecisionaidandtheirchoiceofeventualtreatment AT bobjvanwely associationbetweenpatientspreferredtreatmentaftertheuseofapatientdecisionaidandtheirchoiceofeventualtreatment AT marjanjmeinders associationbetweenpatientspreferredtreatmentaftertheuseofapatientdecisionaidandtheirchoiceofeventualtreatment AT glynelwyn associationbetweenpatientspreferredtreatmentaftertheuseofapatientdecisionaidandtheirchoiceofeventualtreatment AT philiprdereuver associationbetweenpatientspreferredtreatmentaftertheuseofapatientdecisionaidandtheirchoiceofeventualtreatment |