Effect of a Decision Aid on Decision Making for the Treatment of Pelvic Organ Prolapse.

Abstract

The aim of this study was to evaluate if the addition of a decision aid (DA) decreases decisional conflict in women presenting for the management and treatment of pelvic organ prolapse (POP). Women scheduled for the evaluation and management of POP were randomized into either of 2 groups: standard counseling (SC) alone (n = 51) or SC plus a DA (n = 53). Upon completion of their initial visit, patients filled out a 16-item decisional conflict scale and short form general health survey. Values were assessed for normality and compared between groups. Normally distributed, continuous data were evaluated with a Student t test. A χ2 test was used to compare selected categorical characteristics between groups. Differences in distributions of low and high decisional conflict were assessed with a Mann-Whitney U test. One hundred four women were randomized for this analysis. Baseline characteristics, including pelvic prolapse examination measurements, did not significantly differ between groups. The addition of a DA to SC did not significantly lower the level decisional conflict patients faced when deciding on a treatment plan (P = 0.566). There were no significant differences between groups in the following subscores: uncertainty, values clarity, support, effective decision, and informed. In addition, there were no between-group differences in choice of treatment plan (conservative management, pelvic floor physical therapy, pessary, and surgery; P = 0.835). In this relatively small sample, the addition of a DA to SC for women with POP does not significantly decrease the level of decisional conflict in making treatment-related decisions.