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. 2023 Jun;34(6):1243-1252.
doi: 10.1007/s00192-022-05344-w. Epub 2022 Sep 12.

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

Maria B E Gerritse  1   2 , Carlijn F A Smeets  3 , John P F A Heesakkers  4 , Antoine L M Lagro-Janssen  5 , C Huub van der Vaart  6 , Marieke de Vries  7 , Kirsten B Kluivers  3
Affiliations

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

Maria B E Gerritse et al. Int Urogynecol J. 2023 Jun.

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.

Keywords: Barriers; Facilitators; Patient decision aid; Physician; Shared decision making; Stress urinary incontinence.

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Conflict of interest statement

Kirsten Kluivers and Maria Gerritse received a grant for the development of a female SUI patient decision aid, ZonMw: project number 1708823021. The other authors declare that they have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Flow diagram of the response rates of medical specialists and general practitioners: numbers of physicians approached to participate in the study and response rates
See this image and copyright information in PMC

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