Hollands Charlotte, Gray Debra, Marren Andrew, Hindley Richard, Husted Margaret
Department of Psychology, University of Winchester, Hampshire, UK.
Department of Psychology, Kingston University London, London, UK.
BJU Int. 2025 Sep;136(3):359-371. doi: 10.1111/bju.16797. Epub 2025 May 27.
Benign prostatic hyperplasia (BPH) is a complex condition that affects ~3.2 million men in the UK. As men often face multiple treatment options, discussion and consideration of their priorities and preferences is necessary; however, research indicates this is not always adopted in practice.
To evaluate decisional interventions currently available for men with symptomatic BPH, distinct from those designed for prostate cancer.
Eight databases (PubMed, Web of Science, EBSCO, Science Direct, Scopus, Google, Cochrane Library, Centre for Reviews and Dissemination) were searched retrieving a total of 1979 results, of which 13 international studies discussing 10 decision aids (DAs) were included. Studies were eligible that targeted adult males experiencing urological symptoms and discussed any DA designed to promote shared decision making within secondary healthcare.
Narrative synthesis found most DAs focused on treatment information provision; however, risk information was not always equally presented. Most DAs lacked strong theoretical links to existing theories on behaviour change, risk communication, and decision making, and sustained implementation within clinical practice. The most effective aids went beyond information provision, to also elicit and integrate patient preferences and values, by adopting multiple behaviour change techniques (BCTs). Risk of bias indicated medium risk with limited information or justification on data collection and analysis methods.
Current DAs relevant to BPH lack clear focus on individual patient needs required for delivering patient-centred care. Greater transparency and explicit links to behavioural theory and BCTs related to desired future outcomes, expectations, and values are required to effectively create and implement effective interventions into urological practice.
良性前列腺增生（BPH）是一种复杂的病症，在英国约有320万男性受其影响。由于男性通常面临多种治疗选择，因此有必要讨论并考虑他们的优先事项和偏好；然而，研究表明在实际中这一点并非总是能做到。
评估目前可用于有症状BPH男性的决策干预措施，这些措施不同于为前列腺癌设计的干预措施。
检索了八个数据库（PubMed、科学网、EBSCO、科学Direct、Scopus、谷歌、考克兰图书馆、综述与传播中心），共检索到1979条结果，其中包括13项讨论10种决策辅助工具（DAs）的国际研究。纳入的研究对象为有泌尿系统症状的成年男性，并讨论了旨在促进二级医疗保健中共同决策的任何决策辅助工具。
叙述性综合分析发现，大多数决策辅助工具侧重于提供治疗信息；然而，风险信息的呈现并不总是均衡的。大多数决策辅助工具与现有的行为改变、风险沟通和决策理论缺乏紧密的理论联系，也缺乏在临床实践中的持续实施。最有效的辅助工具不仅提供信息，还通过采用多种行为改变技术（BCTs）来引出并整合患者的偏好和价值观。偏倚风险表明为中度风险，在数据收集和分析方法方面信息或理由有限。
目前与BPH相关的决策辅助工具缺乏对提供以患者为中心的护理所需的个体患者需求的明确关注。需要更高的透明度以及与行为理论和与期望的未来结果、期望和价值观相关的行为改变技术建立明确联系，以便有效地创建并在泌尿外科实践中实施有效的干预措施。
