Clinical outcomes after shared decision‐making tools with families of children with obstructive sleep apnea without tonsillar hypertrophy

• Published in: The Laryngoscope 2019-11, Vol.129 (11), p.2646-2651
• Main Authors: Bergeron, Mathieu, Duggins, Angela, Chini, Barbara, Ishman, Stacey L.
• Format: Article
• Language: English
• Subjects: Child; Clinical decision making; Clinical outcomes; Continuous positive airway pressure; decision aids; Decision Making; Decision Support Techniques; decisional conflict; Directive Counseling - methods; Family - psychology; Female; Humans; infant; Male; Obstructive sleep apnea; OSA; pediatric; persistent; Prospective Studies; shared decision making; shared decision‐making tools; Single-Blind Method; Sleep apnea; Sleep Apnea, Obstructive - psychology; Sleep Apnea, Obstructive - therapy; treatment
• ISSN: 0023-852X; 1531-4995
• DOI: 10.1002/lary.27653

Objectives To determine if shared decision‐making tools (SDMTs) improve clinical outcomes for these children. Shared decision making (SDM) is a collaborative process in which patients and clinicians jointly establish treatment plans that integrate clinical evidence and patient values/preferences. We previously reported less decisional conflict using a SDMT for families of children with obstructive sleep apnea (OSA) without tonsillar hypertrophyl; however, the clinical impact of this finding is unknown. Methods Prospective single‐blind randomized controlled trial for consecutive patients referred to a multidisciplinary upper airway center. The study group used a SDMT, whereas the control group did not; all were followed until their next appointment and polysomnogram. Results We assessed 50 families (24 study, 26 controls); mean age of patients was 8.8 (95% confidence interval 6.9–10.6) years, and 44% were female. After their initial visit, there was agreement between families and providers on the best treatment option for 22 of 24 (91.7%) study patients and 12 of 26 (46.2%) controls (P