Carpal Tunnel Syndrome: Assessment of Surgeon and Patient Preferences and Priorities for Decision-Making

Hageman, Michiel G.J.S.; Kinaci, Ahmet; Ju, Kevin L.; Guitton, Thierry G.; Mudgal, Chaitanya S.; Ring, David; Abzug, Joshua M.; Adams, Julie E.; Arbelaez, Gallo Fabio; Aspard, T.; Balfour, George W; Bamberger, H. Brent; Barreto, Romero Jose Camilo; Baskies, Michael A.; Batson, W. Arnold; Baxamusa, Taizoon; Bedout, R. de; Beldner, Steven; Benhaim, Prosper; Benson, Leon S.; Boretto, G. Jorge; Boyer, Martin I.; Byrd, Gregory D.; Calfee, Ryan P.; Zambrano, Gladys Cecilia; Cassidy, Charles; Catalano, Louis W.; Chivers, Karel; Costanzo, Ralph M.; Dantuluri, Phani K.; DeSilva, Gregory L.; Dodds, Seth D.; Evans, John; Felipe, Naquira Escobar Luis; Fernandes, Carlos Henrique; Fischer, Thomas J.; Fischer, Jochen; Fricker, Monty; Frykman, Gary K.; Garcia, Aida E.; Gaston, R. Glenn; Giovanni, Jose Fernando Di; Goldfarb, Charles A.; Grafe, Michael; Grünwald, Hans; Hammert, Warren C.; Hauck, Randy M.; Hernandez, Ricardo German; Hofmeister, Eric P.; Hutchison, Richard L.; Ilyas, Asif M.; Isaacs, Jonathan; Jacoby, Sidney M.; Jebson, Peter J.L.; Jones, Christopher M.; Jones, Michael; Kakar, Sanjeev; Kalainov, David M.; Kaplan, Thomas D.; Kaplan, Saul J.; Katolik, Leonid I.; Kennedy, Stephen A.; Kessler, Michael W.; Kimball, Hervey L.; Kraan, Gerald; Martineau, Paul A.; McAuliffe, John A.; McCabe, Steven J.; McKee, Desirae M.; Merrell, Greg A.; Metzger, Charles; Nancollas, Michael; Nelson, David L.; Nyszkiewicz, R.; Ortíz, José Alfredo Soto; Owens, Patrick W.; Palmer, Jeffrey; Paz, Lior; Pess, Gary M.; Polatsch, Daniel B.; Raia, Frank J.; Richard, Marc J.; Rizzo, Marco; Rozental,; Ruchelsman, David E.; Semenkin, Oleg M.; Sierra, Aguilar Javier Francisco; Siff, Todd E.; Sodha, Samir; Spath, Catherine; Spruijt, S.; Stackhouse, Thomas F.; Swigart, Carrie R.; Szabo, Robert M.; Taras, John S.; Tavakolian, Jason D.; Terrono, Andrew L.; Varecka, Thomas F.; Wahegaonkar, Abhijeet L.; Walsh, Christopher J.; Walter, Frank L.; Weiss, Lawrence; Wills, Brian P.D.; Wilson, Chris; Wilson, Christopher M.; Wolf, Jennifer Moriatis; Wood, Megan M.; Young, Colby

doi:10.1016/j.jhsa.2014.05.035

Cited by 32 publications

(19 citation statements)

References 6 publications

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“…No strong preference for one treatment option [29] Support evidence in favor of one specific treatment option [31,30,3] Physician mentors do not support the use of SDM [33] Patient-related Cognitively able [34] Cognitively unable to participate [31,37,35,23,36] Poor adherence [37] Poor adherence [23] Desire to be involved in decision [34,23] Unwilling to participate [37] Informed about condition [23] Limited insight into condition OR treatment [23,45,33] Less educated [33] Children [35] Condition-and treatmentrelated Chronic disease [31,34,66] Chronic pain [35] Cancer screening and treatment [58,64,59,63,44,65] Emergency medicine [31,34] End of life care [31] Hospital care [specific to psychiatry] [23] Severe disease [34] Diagnostic procedures [23] Multiple treatment options exist [34,38,39,55] Pediatric intensive care [45] Treatment options may affect patient's lifestyle [38,36] support SDM,...…”

Section: Physicianrelatedmentioning

confidence: 99%

Physician attitudes toward shared decision making: A systematic review

Pollard

Bansback

Bryan

2015

Patient Education and Counseling

191

176

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Section: Physicianrelatedmentioning

confidence: 99%

Physician attitudes toward shared decision making: A systematic review

Pollard

Bansback

Bryan

2015

Patient Education and Counseling

191

176

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“…For example, patients with trigger finger or carpal tunnel syndrome were assessed to see what decision-making model they preferred compared to physicians. In both studies, patients preferred to make their own decisions for treatment, while physicians preferred the SDM model [23,24]. A survey of orthopedic physicians conducted by the American Academy of Orthopedic Surgeons reported that patients who have a physician who "listens to patients" and "spends enough time to listen" were very important qualities.…”

Section: Introductionmentioning

confidence: 99%

Current concepts of shared decision making in orthopedic surgery

Klifto

Slover

2017

Curr Rev Musculoskelet Med

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Purpose of review The Shared Decision Making (SDM) model, a collaborative decision making process between the physician and patient to make an informed clinical decision that enhances the chance of treatment success as defined by each patient's preferences and values, has become a new and promising tool in the healthcare process; however, minimal data exists on its application in the orthopedic surgical specialty. Increasing evidence has demonstrated that this once novel idea can be implemented successfully in the orthopedic setting to improve patient outcomes. Recent findings SDM can be applied without significant increases in the office length. Patients report that a physician that takes the time to listen to them is among the most important factors in their care. When time was focused on the SDM process, there was a direct correlation between the time spent with a patient and patient satisfaction. Patients exposed to a decision aid prior to surgery gained a greater knowledge from baseline to make a higher quality decision that was consistent with their values. Involving family members preoperatively can help all patients adhere to postoperative regimens. Exposing patients to a decision aid can reduce expensive elective surgeries, in favor of non-operative management. Incorporating patient goals into the decision-making process has increased satisfaction, compliance, and outcomes.Summary SDM is a two-way exchange of information that attempts to correct the inequality of power between the patient and physician. Decision-aids are helpful tools that facilitate the decision-making process. Treatment decisions are consistent with patient preferences and values when there may be no "best" therapy. A good patient-physician relationship is essential during the process to reduce decisional conflict and increase overall patient outcomes.

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“…7 In clinic visits where patients faced the decision between operative and non-operative treatment for joint arthritis, SDM improved patients’ confidence in their decisions and decreased time to decision-making. 8 Within the field of hand and upper extremity surgery, recent data has indicated discordance between surgeon and patient preferences in decision-making for trigger finger and carpal tunnel syndrome 9,10 . In non-traumatic conditions with an elective operative option and in traumatic conditions without a consensus optimal treatment, patient preference and values ought to be a priority.…”

Section: Introductionmentioning

confidence: 99%

“…In non-traumatic conditions with an elective operative option and in traumatic conditions without a consensus optimal treatment, patient preference and values ought to be a priority. 9 …”

Section: Introductionmentioning

confidence: 99%

Preferences for Shared Decision Making in Older Adult Patients With Orthopedic Hand Conditions

Dardas

Stockburger

Boone

et al. 2016

The Journal of Hand Surgery

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Purpose The practice of medicine is shifting from a paternalistic doctor-patient relationship to a model in which the doctor and patient collaborate to decide optimal treatment. This study aims to determine if the older orthopedic population desires a shared decision making (SDM) approach to their care and to identify patient predictors for the preferred type of approach. Methods This cross-sectional investigation enrolled 99 patients with a minimum age of 65 years, at a tertiary hand specialty practice between March and June 2015. All patients completed the Control Preferences Scale (CPS), a validated system that distinguishes between patient preferences for patient-directed, collaborative, or physician-directed decision-making. Bivariate and logistic regression analyses assessed associations between demographic data, clinic encounter variables such as familiarity with provider, trauma, diagnosis, and treatment decision, and the primary outcome of CPS preferences. Results Eighty one percent of patients analyzed preferred a more patient-directed role in decision making, with 46% of the total cohort citing a collaborative approach as their most preferred treatment approach. Sixty-seven percent cited the most physician-directed approach as their least preferred model of decision-making. Forty-nine percent reported that spending more time with their physician to address questions and explain the diagnosis would be most useful when making a health care decision and 73% preferred additional written informational material. Familiarity with the provider was associated with being more likely to prefer a collaborative approach. Conclusions Older adult patients with symptomatic upper extremity conditions desire more patient-directed roles in treatment decision making. Given the limited amount of reliable information independently obtained outside the office visit, our data suggest that written decision aids offer an approach to shared decision making that is most consistent with the preferences of the older orthopedic patient. Clinical Relevance This study quantifies older adults’ desire to participate in decision making when choosing among treatments for hand conditions.

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Carpal Tunnel Syndrome: Assessment of Surgeon and Patient Preferences and Priorities for Decision-Making

Cited by 32 publications

References 6 publications

Physician attitudes toward shared decision making: A systematic review

Physician attitudes toward shared decision making: A systematic review

Current concepts of shared decision making in orthopedic surgery

Preferences for Shared Decision Making in Older Adult Patients With Orthopedic Hand Conditions

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