Document Detail


Pilot testing of a decision support tool for patients with abdominal aortic aneurysms.
MedLine Citation:
PMID:  21067886     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Patients with abdominal aortic aneurysms (AAAs) who are surgical candidates have as many as three options: open surgery, endovascular surgery, or no surgery. As with all treatment decisions, informed patient preferences are critical. Decision support tools have the potential to better inform patients about the risks and benefits associated with each treatment option and to empower patients to participate meaningfully in the decision-making process. The objective of this study was to develop and pilot test a decision support tool for patients with AAAs.
METHODS: We developed a personalized, interactive, computer-based decision support tool reflecting the most current outcomes data and input from surgeons and patients. We piloted the tool with AAA repair candidates who used the tool prior to meeting with their surgeon. Patients were recruited from a university-based vascular surgery clinic and affiliated VA hospital clinic. To determine feasibility and acceptability, the following outcomes were measured: (1) percent of patients who agreed to participate, (2) length of time required to use the tool, (3) the amount of assistance required to use the tool, and (4) patients' opinions on the acceptability of the tool. To assess effectiveness of the tool, we measured change in knowledge and decisional conflict pre- and post-tool using the paired t-test.
RESULTS: One hundred percent of patients who were approached (n = 12) agreed to participate in the study. The tool was administered in a median time of 35 minutes (range, 25-45 minutes), and all patients were able to navigate the program with minor technical assistance. Mean knowledge scores increased from 56% to 90% (P = .005), and decisional conflict scores decreased from 29% to 8% (P = .04). Overall, patients reported that the program content was balanced across treatment options, presented information clearly and concisely, helped them to organize their thoughts about the decision, and prepared them to talk to their surgeon about what mattered most to them.
CONCLUSIONS: Preliminary evidence suggests that use of an evidence-based AAA decision support tool is feasible and acceptable to patients, increases knowledge, and decreases decisional conflict. Widespread use of such a tool might improve the content and quality of informed consent for this difficult treatment decision.
Authors:
Loren Berman; Leslie Curry; Carolyn Goldberg; Richard Gusberg; Liana Fraenkel
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-11-09
Journal Detail:
Title:  Journal of vascular surgery     Volume:  53     ISSN:  1097-6809     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-31     Completed Date:  2011-03-10     Revised Date:  2014-09-08    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  285-92.e1     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Algorithms
Aortic Aneurysm, Abdominal / surgery*
Attitude of Health Personnel
Blood Vessel Prosthesis Implantation* / adverse effects
Choice Behavior
Conflict (Psychology)
Connecticut
Decision Support Systems, Clinical*
Endovascular Procedures* / adverse effects
Evidence-Based Medicine
Feasibility Studies
Female
Health Knowledge, Attitudes, Practice
Humans
Male
Middle Aged
Patient Education as Topic
Patient Participation*
Patient Satisfaction
Patient Selection*
Physician-Patient Relations
Pilot Projects
Risk Assessment
Risk Factors
Time Factors
Grant Support
ID/Acronym/Agency:
K23 AR048826/AR/NIAMS NIH HHS; K23 AR048826-01 A1/AR/NIAMS NIH HHS; K23 AR048826-05/AR/NIAMS NIH HHS
Comments/Corrections
Comment In:
J Vasc Surg. 2011 Jun;53(6):1757   [PMID:  21609808 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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