Improving the patient decision-making experience for cataract surgery during the COVID-19 era

OBJECTIVE: To explore whether video-based patient decision aids (VBPDAs) for cataract surgery consultation can enhance a patient’s decision-making process while upholding safety regulations during the coronavirus disease 2019 (COVID-19) pandemic. DESIGN: Single-centre consecutive case study. PARTICIPANTS: 147 patients, with an average age of 70 years, who came in for a cataract surgery consult were enrolled in this study. METHODS: All patients watched part 1 of the VBPDA outlining the process of cataract surgery and the decisions involved. Patients then underwent cataract surgery consultation with an ophthalmologist. Afterward, if the patient was indicated for surgery, part 2 of the VBPDA was played. At the end of the visit, all patients completed a survey assessing the effects of COVID-19 safety precautions on their appointment. In addition, patients who had gone forward with surgery complete the Decisional Conflict Scale (DCS). RESULTS: For patients proceeding with cataract surgery, the median DCS score was 9.38 (range, 0–54.69, min–max) on a scale from 0 to 100 (low–high decisional conflict). A DCS score <25 indicates low decisional conflict (n = 76, 68.47%) and a score >25 indicates feeling unsure (n = 35, 31.53%). The DCS also can be separated into various subscales: the informed subscale (median = 8.33; min–max = 0–66.67), values subscale (16.67, 0–58.33), support subscale (8.33, 0–50.00), uncertainty subscale (8.33, 0–83.33), and effective decision subscale (0, 0–37.50). CONCLUSION: Our study found VBPDAs to be an effective tool to enhance the patient decision-making process for cataract surgery during the COVID-19 era.