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Multicenter Study
. 2025 Oct;36(10):1999-2009.
doi: 10.1007/s00192-025-06147-5. Epub 2025 Apr 17.

Shared Decision-Making (SDM) for Female SUI: Current Practice in Three Western Countries

Nienke J E Osse  1   2 , Karine Gontijo-Santos Lima  3 , Marian K Engberts  4 , Hugo W F van Eijndhoven  4 , Wenche M Klerkx  5 , Michiel R de Boer  3 , Philippe D Violette  6 , Laura N Nguyen  7 , Rufus Cartwright  8 ; SDM in SUI Group; Marco H Blanker  3 , Paul L P Brand  9   10
Collaborators, Affiliations
Multicenter Study

Shared Decision-Making (SDM) for Female SUI: Current Practice in Three Western Countries

Nienke J E Osse et al. Int Urogynecol J. 2025 Oct.

Abstract

Introduction: Different decision-making styles can be used to provide counselling for the multiple reasonable treatment options for patients with stress urinary incontinence (SUI). Shared decision-making (SDM) is currently advocated as the preferred style for preference sensitive decisions, as SDM takes patient preferences into account. This study aimed to map the current decision-making process for SUI in three Western countries.

Methods: We included 124 patients and 18 physicians in a multicentre, prospective study in five hospitals in Canada, the United Kingdom and the Netherlands. We used patient and physician versions of the Control Preference Scale (CPS) questionnaires and examined audio-recordings of consultations with the OPTION-5 instrument to assess the degree of SDM.

Results: Most patients (63%) perceived the decision-making as informative, some (29%) as shared and only a few (8%) as paternalistic. Dutch patients more often perceived the decision-making as informative than UK or Canadian patients. Patients' preferred and perceived decision-making styles matched in 70% of consultations. Patients' and physicians' perceptions of decision-making were the same in 60% of consultations, but their perceptions of SDM use did not match. This also did not match the OPTION-5 scores reflecting the use of SDM. Almost all patients were satisfied with the decision-making they perceived.

Conclusion: Most patients and physicians prefer and perceive the current decision-making process as informative decision-making. However, patients and physicians have different perceptions of their mutual consultation. This highlights the imprecise concept of SDM for both patients and physicians.

Keywords: Making; Methods study; Mixed; Patient perceptions; Physician perceptions; Shared decision; Stress urinary incontinence; Treatment decision.

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Conflict of interest statement

Declarations. Ethics statement: Ethical approval was provided by the Local Assessment Committee of Isala Hospital, reference number 20220809, and the Local Assessment Committee of St. Antonius Hospital, reference number R&D/Z23.057. In the UK, the ethical approval was provided by the Health Research Authority and Health and Care Research Wales of the NHS with Research Ethics Committee reference number 23/YH/0086. In Canada, the ethical approval was provided by the Clinical Research Committee at Woodstock Hospital, no reference number provided, and by the Hamilton Health Sciences Integrated Research Ethics Board, reference number 16596. Conflict of interest: None.

Figures

Fig. 1
Fig. 1
The degree of similarity between patients’ preferred and perceived decision-making styles (n = 118)
Fig. 2
Fig. 2
The degree of similarity between patients’ and physicians’ perceived decision-making styles (n = 119)
Fig. 3
Fig. 3
The degree of similarity between patients’ and physicians’ perceived use of shared decision-making (n = 108)
See this image and copyright information in PMC

References

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