Decisional Control Preferences in Managing Intraductal Papillary Mucinous Neoplasms of the Pancreas.

OBJECTIVES

To evaluate patient preferences for decision-making role in the management of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas and to identify characteristics associated with those preferences.

BACKGROUND

Management of IPMNs is rooted in uncertainty with guidelines failing to incorporate patients' preferences.

MATERIALS AND METHODS

A representative sample of participants evaluated a clinical vignette with the option to undergo surgery or surveillance for their IPMN. Their preferred role in decision-making was evaluated using the Control Preference Scale. The relationship between control preference and demographic/psychosocial variables was analyzed.

RESULTS

Of the 520 participants in the study, most preferred an active role (65%), followed by shared (29%), and passive roles (6%) in the decision-making process. Lower health literacy was significantly associated with more passive control preference ( P  = 0.003). Non-active preference was significantly associated with Latino race compared to White race (odds ratio = 0.52, P  = 0.009). We found no significant association between control preference and education level or cancer anxiety.

CONCLUSIONS

Most patients prefer an active role in IPMN treatment decisions. Lower health literacy and Latino race were associated with a preference for non-active decision roles. Clinicians should strive to align patient involvement in IPMN treatment decisions with their patient's preferred role.