Our interest in shared decision making began with a question: Why do rates of surgical procedures for prostate disease vary so much from one geographic location to another? We discovered one main reason for this practice variation was that patients were not being informed of their available treatment options. Determined to address this issue, we developed our first patient decision aid for benign prostatic hyperplasia (BPH) and through implementation of the tool, we saw a glimpse of a remarkable trend that medical research has proven time and again. When patients are fully informed of all their available treatment options, they make choices that are more aligned with their preferences and values; therefore, leading to a higher quality of care. This knowledge was just the beginning of our work to engage patients and providers in a shared decision making process.
The rationale for decision aids is addressed in the accompanying paper. Unlike hormone replacement therapy, prostate surgery is a "Rubicon" procedure -- that is, once undertaken it cannot be reversed. In the United States, a pilot study on the impact of a programme to aid in decisions about benign prostatic hyperplasia showed a 40% decrease in surgery rates. This finding was not replicated in a subsequent randomised controlled trial.
Posted in Patient Decision Aids, Patient Involvement, Special Populations
Tagged Angela Coulter, benign prostatic hyperplasia, BMJ, BPH, decision aids, decision making, men, multimedia, primary care, prostatectomy, Shared Decision-Making® programs, treatment decisions
Many men face decisions about treatments for an enlarged prostate and the treatment options may cause much confusion. To help men understand their options, the Foundation has developed a Shared Decision-Making® Program called Treatment Choices for Benign Prostatic Hyperplasia.