Bouhadana David, Nguyen David-Dan, Raizenne Brendan, Schwarcz Joe, Gordon Harvey, Chughtai Bilal, Elterman Dean S, Lavallée Luke T, Martin Paul, McAlpine Kristen, Paterson Ryan, Razvi Hassan, Zorn Kevin C, Bhojani Naeem
Faculty of Medicine, McGill University, Montreal, QC, Canada.
Division of Urology, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada.
Can Urol Assoc J. 2021 Aug;15(8):247-254. doi: 10.5489/cuaj.7492.
The growing number of surgical options available to treat benign prostatic hyperplasia (BPH), may overwhelm patients and urologists when deciding on an optimal treatment. Therefore, we developed an online patient decision aid (PtDA) that includes all guideline-approved surgical modalities. The objective of this study was to assess the acceptability of the PtDA among former BPH surgery patients and urologists that treat BPH surgically.
The International Patient Decision Aids Standards were used to develop a PtDA that includes monopolar transurethral resection of the prostate (TURP), bipolar TURP, GreenLight photovaporization, endoscopic enucleation of the prostate, Rezum, Urolift, Aquablation, open retropubic prostatectomy, and robotic simple prostatectomy as management options. Eleven urologists that regularly treat BPH and 19 patients who received BPH surgery were recruited. Alpha-testing was performed using a validated acceptability scoring system.
For all sections of the PtDA, most urologists agreed that the language used was easy to follow (91.9%), that the amount of information provided was adequate (63.6%), that the length of the PtDA was appropriate (63.6%), and that the outcomes reported were correct (81.8%). All 19 patient participants agreed that the language used was easy to follow, and most found that the amount of information provided was adequate (84.2%), that the length of the PtDA was appropriate (84.2%), and that the outcomes reported were well-explained (89.5%).
Our PtDA was found to be acceptable among urologists and patients. These results demonstrate that most of the participants either recommend the use of this tool or plan to incorporate it in their clinical practice.
治疗良性前列腺增生(BPH)的手术选择日益增多,这可能会让患者和泌尿外科医生在决定最佳治疗方案时感到不知所措。因此,我们开发了一种在线患者决策辅助工具(PtDA),其中包括所有指南认可的手术方式。本研究的目的是评估该PtDA在前BPH手术患者和通过手术治疗BPH的泌尿外科医生中的可接受性。
采用国际患者决策辅助工具标准开发了一种PtDA,其中包括经尿道前列腺单极切除术(TURP)、双极TURP、绿激光汽化术、前列腺内镜剜除术、Rezum、Urolift、水刀前列腺切除术、耻骨后开放性前列腺切除术和机器人单纯前列腺切除术作为治疗选择。招募了11名经常治疗BPH的泌尿外科医生和19名接受过BPH手术的患者。使用经过验证的可接受性评分系统进行alpha测试。
对于PtDA的所有部分,大多数泌尿外科医生一致认为所使用的语言易于理解(91.9%)、提供的信息量充足(63.6%)、PtDA的长度合适(63.6%)以及报告的结果正确(81.8%)。所有19名患者参与者都认为所使用的语言易于理解,并且大多数人认为提供的信息量充足(84.2%)、PtDA的长度合适(84.2%)以及报告的结果解释得很好(89.5%)。
我们的PtDA在泌尿外科医生和患者中被认为是可接受的。这些结果表明,大多数参与者要么推荐使用该工具,要么计划将其纳入临床实践。