MP9-12 PATIENT-CENTERED TREATMENT DECISIONS: USING CONJOINT ANALYSIS AS AN AID FOR SHARED DECISION-MAKING FOR URETHRAL STRICTURE TREATMENT

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Evidence-based Medicine & Outcomes II1 Apr 2015MP9-12 PATIENT-CENTERED TREATMENT DECISIONS: USING CONJOINT ANALYSIS AS AN AID FOR SHARED DECISION-MAKING FOR URETHRAL STRICTURE TREATMENT Lindsay Hampson, Thomas Gaither, Leslie Wilson, Jie Ting, Isabel Allen, and Benjamin Breyer Lindsay HampsonLindsay Hampson More articles by this author , Thomas GaitherThomas Gaither More articles by this author , Leslie WilsonLeslie Wilson More articles by this author , Jie TingJie Ting More articles by this author , Isabel AllenIsabel Allen More articles by this author , and Benjamin BreyerBenjamin Breyer More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.372AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Understanding patient preferences for treatment decisions helps to assist in shared decision-making and places emphasis on patient-centered outcomes. Conjoint analysis (CA) has recently been proposed as a method to understand patient preferences and what risks patients are willing to take in terms of side effects and treatment options for what gains. Our objective was to evaluate whether use of a choice-based CA exercise helped to improve patients' decision-making ability about treatment preferences for management of urethral stricture disease. METHODS Male patients with urethral stricture disease completed a 3-part survey consisting of 1) assessment of decisional conflict regarding surgical management of urethral stricture disease using the validated SURE scale, 2) a choice-based CA where participants were presented with a series of 16 random and 2 fixed treatment scenarios from which they had to choose, and 3) a re-assessment of their decisional conflict and evaluation of the usefulness of the CA. RESULTS 177 patients completed the exercise. Prior to completing the CA, 50% reported having decisional conflict about what treatment option to pursue, whereas after the conjoint analysis only 45% had decisional conflict (p < 0.05). 71% of participants felt that the CA was helpful in deciding what was important in making a treatment decision, and 81% felt that it helped them to express their priorities and preferences for side effects and outcomes of surgical management. Participants who had previously undergone urethroplasty and were younger were less likely to have decisional conflict both before and after the conjoint survey (p < 0.01 for all). Men who reported that the CA helped them to express their priorities and preferences were significantly more likely to make a change from having decisional conflict to not having conflict after completion of the CA (p = 0.04). CONCLUSIONS Choice-based CA improves patients' ability to make treatment decisions, to understand and express their treatment preferences, and decreases decisional conflict. CA can be used as a tool to aid in shared decision-making with a focus on patient-centered outcomes. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e106-e107 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Lindsay Hampson More articles by this author Thomas Gaither More articles by this author Leslie Wilson More articles by this author Jie Ting More articles by this author Isabel Allen More articles by this author Benjamin Breyer More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...