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. 2024 Nov;43(8):2052-2059.
doi: 10.1002/nau.25578. Epub 2024 Sep 5.

Supporting the Choice for Conservative and Surgical Treatment in Female Stress Urinary Incontinence: Development and Evaluation of a Patient Decision Aid

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

Supporting the Choice for Conservative and Surgical Treatment in Female Stress Urinary Incontinence: Development and Evaluation of a Patient Decision Aid

Maria B E Gerritse et al. Neurourol Urodyn. 2024 Nov.

Abstract

Introduction: Making a treatment decision for female stress urinary incontinence (SUI) can be challenging for patients and healthcare providers. Dutch guidelines advise to counsel both pelvic floor muscle therapy and midurethral sling surgery as primary treatment options in uncomplicated moderate to severe cases. The use of a patient decision aid (PDA) can support decision-making, reduce decisional conflict and decisional regret, and increase knowledge. The aim of this study was to develop and evaluate an online PDA for females (SUI).

Methods: This mixed-methods study was performed in consecutive stages by a multidisciplinary working group. PDA design was based on the International Patient Decision Aids Standards (IPDAS) and on outcomes of needs assessments amongst patients and healthcare providers. Content was based on Dutch guidelines, targeted literature searches and patient information from the Dutch scientific society for gynecology. The concept version was evaluated by patients, patients' advocates, and healthcare providers.

Results: Using the nominal group technique, the working group established the design and format of the PDA. Fifty-six out of 58 applicable items of the IPDAS were met. The PDA contains information on the condition, advice on lifestyle adaptations, and describes surgical and nonsurgical treatment options. The option grid contains comparisons of the primary treatment options. Furthermore, value clarification exercises and narratives were included. Acceptability and usability evaluation of the concept version was performed by 15 healthcare providers, three patients, and two patients' advocates. Comments were processed in the working group, resulting in the final version of the PDA, which was supported by all assessors.

Conclusion: Our multidisciplinary working group developed an online PDA for women with moderate to severe SUI including conservative and surgical treatment options, based on IPDAS criteria, guidelines, scientific evidence, and needs assessments from patients and healthcare providers. This PDA is supported by patients, healthcare providers, scientific societies, and the Dutch patients' association. The next step is to evaluate and implement this PDA in daily practice.

Trial registration: ID 2014-308.

Keywords: decision aid; development; midurethral sling; pelvic floor muscle therapy; shared decision making; stress urinary incontinence; treatment.

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References

    1. B. T. Haylen, D. de Ridder, R. M. Freeman, et al., “An International Urogynecological Association (IUGA)/International Continence Society (ICS) Joint Report on the Terminology for Female Pelvic Floor Dysfunction,” International Urogynecology Journal 21, no. 1 (2010): 5–26.
    1. J. M. Wu, C. A. Matthews, M. M. Conover, V. Pate, and M. Jonsson Funk, “Lifetime Risk of Stress Urinary Incontinence or Pelvic Organ Prolapse Surgery,” Obstetrics & Gynecology 123, no. 6 (2014): 1201–1206.
    1. M. Abufaraj, T. Xu, C. Cao, et al., “Prevalence and Trends in Urinary Incontinence Among Women in the United States, 2005‐2018,” American Journal of Obstetrics and Gynecology 225, no. 2 (2021): 166.e1‐e12.
    1. C. Dumoulin, L. P. Cacciari, and E. J. C. Hay‐Smith, “Pelvic Floor Muscle Training Versus No Treatment, or Inactive Control Treatments, for Urinary Incontinence in Women,” Cochrane Database of Systematic Reviews 10, no. 10 (2018): Cd005654.
    1. A. A. Ford, L. Rogerson, J. D. Cody, P. Aluko, and J. A. Ogah, “Mid‐Urethral Sling Operations for Stress Urinary Incontinence in Women,” Cochrane Database of Systematic Reviews 7, no. 7 (2017): Cd006375.

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