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The association between patients' preferred treatment after the use of a patient decision aid and their choice of eventual treatment

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...

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Autores principales: Latenstein, Carmen S. S., Thunnissen, Floris M., Thomeer, Bastiaan J. M., van Wely, Bob J., Meinders, Marjan J., Elwyn, Glyn, de Reuver, Philip R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7321744/
https://www.ncbi.nlm.nih.gov/pubmed/32167653
http://dx.doi.org/10.1111/hex.13045
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author Latenstein, Carmen S. S.
Thunnissen, Floris M.
Thomeer, Bastiaan J. M.
van Wely, Bob J.
Meinders, Marjan J.
Elwyn, Glyn
de Reuver, Philip R.
author_facet Latenstein, Carmen S. S.
Thunnissen, Floris M.
Thomeer, Bastiaan J. M.
van Wely, Bob J.
Meinders, Marjan J.
Elwyn, Glyn
de Reuver, Philip R.
author_sort Latenstein, Carmen S. S.
collection PubMed
description 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.
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spelling pubmed-73217442020-06-30 The association between patients' preferred treatment after the use of a patient decision aid and their choice of eventual treatment Latenstein, Carmen S. S. Thunnissen, Floris M. Thomeer, Bastiaan J. M. van Wely, Bob J. Meinders, Marjan J. Elwyn, Glyn de Reuver, Philip R. Health Expect Original Research Papers 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. John Wiley and Sons Inc. 2020-03-13 2020-06 /pmc/articles/PMC7321744/ /pubmed/32167653 http://dx.doi.org/10.1111/hex.13045 Text en © 2020 The Authors Health Expectations published by John Wiley & Sons Ltd This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research Papers
Latenstein, Carmen S. S.
Thunnissen, Floris M.
Thomeer, Bastiaan J. M.
van Wely, Bob J.
Meinders, Marjan J.
Elwyn, Glyn
de Reuver, Philip R.
The association between patients' preferred treatment after the use of a patient decision aid and their choice of eventual treatment
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 Original Research Papers
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7321744/
https://www.ncbi.nlm.nih.gov/pubmed/32167653
http://dx.doi.org/10.1111/hex.13045
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