Physicians’ perspectives on using a patient decision aid in female stress urinary incontinence

Abstract

Introduction and hypothesis A treatment choice for female stress urinary incontinence (SUI) is preference sensitive for both patients and physicians. Multiple treatment options are available, with none being superior to any other. The decision-making process can be supported by a patient decision aid (PDA). We aimed to assess physicians’ perceptions concerning the use of a PDA. Methods In a mixed methods study, urologists, gynecologists and general practitioners in the Netherlands were asked to fill out a web-based questionnaire. Questions were based on the Tailored Implementation for Chronic Diseases checklist using the following domains: guideline factors, individual health professional factors, professional interactions, incentives and resources, and capacity for organizational change. Participants were asked to grade statements using a five-point Likert scale and to answer open questions on facilitators of and barriers to implementation of a PDA. Outcomes of statement rating were quantitatively analyzed and thematic analysis was performed on the outcomes regarding facilitators and barriers. Results The response rate was 11%, with a total of 120 participants completing the questionnaire. Ninety-two of the physicians (77%) would use a PDA in female SUI. Evidence-based and unbiased content, the ability to support shared decision making, and patient empowerment are identified as main facilitators. Barriers are the expected prolonged time investment and the possible difficulty using the PDA in less health-literate patient populations. Conclusions The majority of physicians would use a PDA for female SUI. We identified facilitators and barriers that can be used when developing and implementing such a PDA.

Evaluation of the effect of an online patient decision aid for female stress urinary incontinence: protocol for a stepped wedge study (the Decision study)

“…These criteria are put forward by researchers, practitioners and stakeholders worldwide, united in the IPDAS Collaboration, to enhance the quality and effectiveness of PDAs (10). Furthermore, a needs' assessment was performed among patients (17) and facilitators and barriers for use by a HCP (18) were identi ed. Outcomes of both assessments were incorporated in the PDA to ensure appropriateness for the target audience and to enhance implementation in daily practice.…”