Patient Reactions to a Program Designed to Facilitate Patient Participation in Treatment Decisions for Benign Prostatic Hyperplasia

Barry, Michael J.; Fowler, Floyd J.; Mulley, Albert G.; Henderson, Joseph V.; Wennberg, John E.

doi:10.1097/00005650-199508000-00003

Cited by 339 publications

(169 citation statements)

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“…In the early 1980s, researchers began experimenting with this technology in the field of urology 2 . Interactive computer video programs were developed for patients with symptoms of benign prostatic hyperplasia.…”

Section: Resultsmentioning

confidence: 99%

Assessment of the Feasibility and Impact of Shared Decision Making in Prostate Cancer

Onel

Hamond

Wasson

et al. 1998

Urology

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Section: Resultsmentioning

confidence: 99%

Assessment of the Feasibility and Impact of Shared Decision Making in Prostate Cancer

Onel

Hamond

Wasson

et al. 1998

Urology

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“…Patients were invited to review the in-consultation diagrams and booklet through a structured interview. Feasibility and acceptability, including the amount, length and clarity of information, and usefulness of the DA, were assessed by a 10-item questionnaire adapted from Fiset et al (2000) and Barry et al (1995) to assess acceptability of shared decision-making programmes. Patient anxiety, as another measure of acceptability of the aid, and knowledge were measured using a pre-/post-test design, using the 20-item State-Trait Anxiety Inventory (STAI Form Y) and a 16-item scale adapted from Fiset et al (2000) and Brundage et al (2001).…”

Section: Pilot-testing In Advanced Lung Cancer Patientsmentioning

confidence: 99%

Enhancing treatment decision-making: pilot study of a treatment decision aid in stage IV non-small cell lung cancer

et al. 2008

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We developed a decision aid (DA) for patients with metastatic non-small cell lung cancer (NSCLC), to better inform patients of their prognosis and treatment options, and facilitate involvement in decision-making. In a pilot study, 20 patients with metastatic NSCLC attending outpatient clinics at a major cancer centre, who had already made a treatment decision, reviewed acceptability of the DA. The median age of the patients was 61 years (range 37 -77 years), 35% were male, 20% had a university education, and most (75%) had English as a first language. Most had received chemotherapy, with 65% currently on treatment. Patients were not anxious at baseline and had clear understanding of the goals and toxicity of chemotherapy in advanced NSCLC. After reviewing the DA, patients' anxiety decreased slightly (P ¼ 0.04) and knowledge scores improved by 25% (Po0.001). Most improvements in understanding were of prognosis with and without chemotherapy, although patients still believed advanced NSCLC to be curable. Patients rated the DA highly with respect to information clarity, usefulness and were positive about its use in practice, although 40% found the prognostic information slightly upsetting. The DA for advanced NSCLC is feasible, acceptable to patients and improves understanding of advanced NSCLC without increasing patient anxiety.

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“…Michael Barry and colleagues used scaling tasks similar to those proposed and calculated the strength of association between measured values and subsequent treatment of BPH. 19 Using a logistic regression model to control for other variables, patients who had used the BPH decision aid and were very bothered by symptoms were seven times more likely to have surgery than those not so bothered. Patients who were very bothered by the prospect of sexual dysfunction were one-fifth as likely to have surgery as those not so bothered.…”

Section: New Measures Of Decision Qualitymentioning

confidence: 99%

Policy Support For Patient-Centered Care: The Need For Measurable Improvements In Decision Quality

2004

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The phenomenon of practice variation draws attention to the need for better management of clinical decision making as a means of ensuring quality. Different policies to address variations, including guidelines and measures of appropriateness, have had little demonstrable impact on variation itself or on the underlying quality problems. Variations in rates of interventions raise questions about the patient-centeredness of decisions that determine what care is provided to whom. Policies that support the development and routine use of measures of decision quality will provide opportunities to measurably improve the quality of decisions, thereby leading to more patient-centered and efficient health care. S t r i k i n g va r i at i o n s i n r at e s of common surgical procedures among seemingly similar populations have been documented for more than sixty years. Variation is greatest when there is legitimate discretion about the best course of action. 1 Sometimes this discretion exists because of inadequate research and the resulting collective professional uncertainty about the effectiveness of an intervention. Sometimes research is adequate but is variably interpreted or disseminated, which results in individual professional uncertainty. In some cases, two or more interventions may be equally effective. Under these circumstances, local conventional wisdom shaped by the beliefs of local medical opinion leaders can take over, masking uncertainty and driving procedure rates in one direction or the other. The result is often an idiosyncratic pattern of rates that John Wennberg has labeled the "surgical signature" of a particular geographic area. 2 The cost and quality implications of these geographic differences are too great to be ignored. 3 One response of policymakers to practice variation has been to urge professional organizations and researchers to develop clinical practice guidelines to as-VA R -5 4 7 O c t o b e r 2 0 0 4

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Patient Reactions to a Program Designed to Facilitate Patient Participation in Treatment Decisions for Benign Prostatic Hyperplasia

Cited by 339 publications

References 0 publications

Assessment of the Feasibility and Impact of Shared Decision Making in Prostate Cancer

Assessment of the Feasibility and Impact of Shared Decision Making in Prostate Cancer

Enhancing treatment decision-making: pilot study of a treatment decision aid in stage IV non-small cell lung cancer

Policy Support For Patient-Centered Care: The Need For Measurable Improvements In Decision Quality

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