Treatment Preferences of Patients With Benign Prostatic Hyperplasia Before and After Using a Web-based Decision Aid

• Published in: Urology (Ridgewood, N.J.) N.J.), 2020-03, Vol.137, p.138-145
• Main Authors: Lamers, Romy E.D., van der Wijden, Fieke C., de Angst, Isabel B., de Vries, Marieke, Cuypers, Maarten, van Melick, Harm H.E., de Beij, Jeltje S., Oerlemans, Dennis J.A.J., van de Beek, Kees, Bosch, Ruud J.L.H. R., Kil, Paul J.M.
• Format: Article
• Language: English
• Subjects: Aged; Conservative Treatment - methods; Conservative Treatment - psychology; Decision Making; Decision Support Techniques; Humans; Internet-Based Intervention; Life Style; Lower Urinary Tract Symptoms - etiology; Lower Urinary Tract Symptoms - psychology; Lower Urinary Tract Symptoms - therapy; Male; Middle Aged; Netherlands; Outcome Assessment, Health Care; Patient Preference - statistics & numerical data; Prostatic Hyperplasia - pathology; Prostatic Hyperplasia - physiopathology; Prostatic Hyperplasia - psychology; Prostatic Hyperplasia - therapy; Quality of Life; Surgical Procedures, Operative - methods; Surgical Procedures, Operative - psychology; Surveys and Questionnaires; Watchful Waiting
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/j.urology.2019.12.026

To evaluate treatment preferences of patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) before and after using a web-based decision aid (DA). Between July 2016 and January 2017 patients were invited to use a web-based LUTS/BPH DA. Treatment preferences (for lifestyle advices, medication or surgery) before and after DA use and responses on values clarification exercises were extracted from the DA. In total, 126 patients were included in the analysis. Thirty-four percent (43/126) had not received any previous treatment and were eligible for (continuation of) lifestyle advices or to start medication, as initial treatment. The other 66% (83/126) did use medication and were eligible, either for continuing medication or to undergo surgery. Before being exposed to the DA, 67 patients (53%) were undecided and 59 patients (47%) indicated an initial treatment preference. Half of the patients who were initially undecided were able to indicate a preference after DA use (34/67, 51%). Of those with an initial preference, 80% (47/59) confirmed their initial preference after DA use. Five out of 7 values clarification exercises used in the DA were discriminative between final treatment preferences. In 79%, the treatment preferred after DA use matched the received treatment. Overall, healthcare providers were positive about DA feasibility. Our findings suggest that a LUTS/BPH DA may help patients to confirm their initial treatment preference and support them in forming a treatment preference if they did not have an initial preference.