Creating a Decision Aid to Better Manage the Symptoms of Gastroparesis: A Multidisciplinary Approach to Informed Shared Decision Making for Patients

Abstract

Introduction: Gastroparesis is a disabling, chronic gastrointestinal disorder marked by symptoms such as extreme nausea and frequent vomiting. A decision aid with interactive, visual media will be tested with gastroparetic patients to describe two new, patient-controlled approaches to symptom management for facilitation of informed shared decision making between patient and provider as well as a guide to being active in your healthcare using the PACE-talk approach, a successful patient communication skills training program. Methods: An application is under production for two newly created techniques to better manage the symptoms of gastroparesis. Health communication scholars collaborate with a patient expert to promote effective communication with physicians following the active patient communication training program called PACE-talk. One method designed by a GI surgeon describes programmable needleless acupuncture at the P6 point located at the wrist, a method termed transcutaneous electrical acupuncture. The other method is designed by a team of GIs and biomedical research scientists and describes autonomous neural control that personalizes gastric electrical stimulator (GES) adjustments -implants common with gastroparetics - allowing the patient to identify and treat their symptoms as part of the treatment loop. By allowing patients to treat their own symptoms, patients feel more active in their healthcare; patients choosing GES therapy or acupuncture can participate in symptom management and thus control their own outcome for a better quality of life. These interactive videos will be tested with 25 gastroparetic patients for feedback on content, design, and appearance. Qualitative analysis using grounded theory will be used to develop a codebook to further develop a working iteration of the application. Results: While early designs for the prototype have been accepted to the 2015 ISDM-ISEHC conference in Sydney, the first working model will be available for ACG 2015. This project is a work in progress. Conclusion: Based on the results this translational study, the team will develop a fully working model that can be uploaded to patient portals or accessed by a QR code for user-friendly app that can be downloaded to any smartphone. This unique, multidisciplinary approach combines health communication and innovative biomedical techniques to facilitate an informed SDM tool in an easy-to-understand format with guidance from expert gastroparetic patients themselves.