Abstract
BackgroundFor both gallbladder removal and inguinal hernia repair, it is important to include patients’ perspective in the decision-making process, as watchful waiting is an accepted alternative in selected patients. The aim of this study was to evaluate operation rates before and after implementation of decision aids (DAs) and to assess patient compliance with the use of DAs.MethodsA single-centered retrospective study was performed, including all patients ≥18 years referred to the surgical outpatient clinic with symptomatic gallstones or an inguinal hernia between January 2014 and December 2017. Operation rates before and after implementation of DAs (December 2015) were compared. In addition, patient compliance with the use of DAs and satisfaction with final treatment were assessed.ResultsOverall, 1625 patients with gallstones and 1798 patients with an inguinal hernia were included. After implementation, DAs were provided to 512 patients (63.1%) with gallstones of whom 80.7% (413/512) used the DA and to 528 patients (58.8%) with an inguinal hernia, which was used by 80.7% (426/528). Before implementation, the operation rate in patients with gallstones was 72.0% (586/814) and after implementation 56.7% (460/811) (− 15.3%, p < 0.001). The operation rate in patients with an inguinal hernia decreased from 77.8% (700/900) to 64.6% (580/898) (− 13.2%, p < 0.001). Patient satisfaction with final treatment was high (9/10).ConclusionImplementation of DAs in the surgical outpatient clinic for patients with gallstones or an inguinal hernia is associated with reduced elective operation rates and is associated with high DA compliance.
Highlights
Gallbladder removal and inguinal hernia repair are the two most commonly performed surgical procedures worldwide [1, 2]
Operation rates for gallbladder removal and inguinal hernia repair in the intervention hospital substantially declined over the years 2014–2017 (Fig. 2)
The present study shows reduced elective operation rates and preservation of patient satisfaction after the implementation of decision aids (DAs) in patients with gallstones or an inguinal hernia
Summary
Gallbladder removal and inguinal hernia repair are the two most commonly performed surgical procedures worldwide [1, 2]. Shared decision making (SDM) as a model for treatment decisions balances patient’s preferences, medical expertise of the doctor and For both gallbladder removal and inguinal hernia repair, it is important to include patients’ perspective in the decision-making process, as watchful waiting is an accepted alternative in selected patients. The aim of this study was to evaluate operation rates before and after implementation of decision aids (DAs) and to assess patient compliance with the use of DAs. Methods A single-centered retrospective study was performed, including all patients C18 years referred to the surgical outpatient clinic with symptomatic gallstones or an inguinal hernia between January 2014 and December 2017. Conclusion Implementation of DAs in the surgical outpatient clinic for patients with gallstones or an inguinal hernia is associated with reduced elective operation rates and is associated with high DA compliance
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