Abstract: PD09-07
Sources of Funding: Supported in part by the H. H. Lee Research Program.

Introduction

Shared decision making (SDM) allows patients and physicians to develop a treatment plan together by thoroughly exploring clinical risks and benefits in the setting of patient-specific values and concerns. This method of counseling can help to reduce decisional conflict, which has been identified as an indicator of decisional quality. Using novel SDM software, we aimed to examine the impact of shared decision making interventions on decisional conflict in patients seeking treatment for benign prostatic hyperplasia (BPH).

Methods

All new patients evaluated for BPH were offered SDM software before their initial urologic visit either in person or by phone. Willing participants utilized the software at home or in the waiting area prior to their visit. The software provides education, preference assessment for relevant outcomes, and personalized decision analysis for the patient. A report from the software is sent to the counseling urologist and the patient. Following consultation with a urologist, patients completed a follow up questionnaire measuring disease-specific knowledge, satisfaction with care, and decisional conflict using the validated SURE scale (SURE=4, high decisional quality; SURE= 0-3, low decisional quality). Questionnaire results were compared to baseline data collected from patients who did not receive the SDM module.

Results

Data was available for 35 men in the SDM pilot group and 103 men from the control group. They were well matched in demographics and health literacy. Among all participants, significantly fewer men in the SDM group felt unsure regarding treatment options (12% vs 37%, p = 0.0059) and were more likely to have made a shared decision (SDM score 1.87 vs 2.19, p=0.0503). There was no significant difference in overall SURE score between control and pilot study participants (3.0 vs 2.7, p=0.3). Among participants who reported some decisional conflict (n=76), SDM pilot study participants were more likely to report adequate support to make a treatment choice than the control participants (82% vs 57%, p = 0.0564).

Conclusions

Our interim analysis of a novel SDM intervention for men with BPH shows an improvement in understanding treatment options and shared decision making. The SDM software provided additional support among those patients who felt some decision conflict after their initial consultation. These differences may become more significant as we accrue more pilot-study patients.

Funding

Supported in part by the H. H. Lee Research Program.