| Randomized trial of a decision aid for patients with cystic fibrosis considering lung transplantation. | |
| | |
MedLine Citation:
|
PMID: 19590021 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
RATIONALE: We developed an evidence-based decision aid for patients with advanced cystic fibrosis considering referral for lung transplantation. OBJECTIVES: To prospectively evaluate whether use of the decision aid increased knowledge about the options, improved realistic expectations, and decreased decisional conflict in adult patients. METHODS: We performed a single-blind randomized controlled trial involving 149 adult patients with cystic fibrosis with an FEV(1) <or= 40% predicted from 14 Canadian and Australian centers. All participants received an education and counseling session from their cystic fibrosis team and were then randomized to receive the decision aid or usual care. The decision aid is available online at http://decisionaid.ohri.ca/decaids.html. MEASUREMENTS AND MAIN RESULTS: The primary end points measured were participants' knowledge, realistic expectations, and decisional conflict evaluated 3 weeks after randomization. Patients randomized to the decision aid had greater knowledge about their options (P < 0.0001) and had more realistic expectations about the benefits and risks of lung transplantation (P < 0.0001) compared with those randomized to usual care. The total decisional conflict score was significantly lower in the decision aid group 3 weeks postrandomization compared with the usual care group (11.6 vs. 20.4; P = 0.0007). Decisions were durable; 88% of patients in the decision aid group and 75% in the usual care group maintained the same choice 12 months after randomization (P = 0.06). CONCLUSIONS: Use of a decision aid for patients with cystic fibrosis considering referral for lung transplantation, in addition to usual education and counseling, improves patient knowledge, realistic expectations, decisional conflict, and patient satisfaction. Clinical trial registered with www.clinicaltrials.gov (NCT00345449). |
| | |
Authors:
|
Katherine L Vandemheen; Annette O'Connor; Scott C Bell; Andreas Freitag; Peter Bye; Alphonse Jeanneret; Yves Berthiaume; Neil Brown; Pearce Wilcox; Gerard Ryan; Nancy Brager; Harvey Rabin; Nancy Morrison; Peter Gibson; Mary Jackson; Nigel Paterson; Peter Middleton; Shawn D Aaron |
Publication Detail:
|
Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2009-07-09 |
Journal Detail:
|
Title: American journal of respiratory and critical care medicine Volume: 180 ISSN: 1535-4970 ISO Abbreviation: Am. J. Respir. Crit. Care Med. Publication Date: 2009 Oct |
Date Detail:
|
Created Date: 2009-10-06 Completed Date: 2009-11-02 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9421642 Medline TA: Am J Respir Crit Care Med Country: United States |
Other Details:
|
Languages: eng Pagination: 761-8 Citation Subset: AIM; IM |
Affiliation:
|
Ottawa Health Research Institute, University of Ottawa, Ottawa, Ontario, Canada. |
| Data Bank Information | |
Bank Name/Acc. No.:
|
ClinicalTrials.gov/NCT00345449 |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Cystic Fibrosis / psychology, surgery* Decision Making, Computer-Assisted* Decision Support Techniques Female Health Knowledge, Attitudes, Practice* Humans Lung Transplantation / psychology* Male Patient Education as Topic Patient Participation* Young Adult |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Bronchoalveolar lavage enzyme-linked immunospot for a rapid diagnosis of tuberculosis: a Tuberculosi...
Next Document: Granulocyte-macrophage colony-stimulating factor to reverse sepsis-associated immunosuppression: a d...