Maria B E Gerritse1,2, Carlijn F A Smeets3, John P F A Heesakkers4, Antoine L M Lagro-Janssen5, C Huub van der Vaart6, Marieke de Vries7, Kirsten B Kluivers3. 1. Department of Gynecology, Radboud University Medical Center, Geert Grooteplein Zuid 10, Postbus 9101, 6500, HB, Nijmegen, The Netherlands. maaike.gerritse@radboudumc.nl. 2. Department of Obstetrics and Gynecology, Gelderse Vallei Hospital, Ede, The Netherlands. maaike.gerritse@radboudumc.nl. 3. Department of Gynecology, Radboud University Medical Center, Geert Grooteplein Zuid 10, Postbus 9101, 6500, HB, Nijmegen, The Netherlands. 4. Department of Urology, Maastricht University Medical Centre, Maastricht, The Netherlands. 5. Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands. 6. Department of Gynecology, University Medical Centre Utrecht, Utrecht, The Netherlands. 7. Institute for Computing and Information Sciences, Radboud University, Nijmegen, The Netherlands.
Abstract
INTRODUCTION AND HYPOTHESIS: A treatment choice for female stress urinary incontinence (SUI) is preference sensitive for both patients and physicians. Multiple treatment options are available, with none being superior to any other. The decision-making process can be supported by a patient decision aid (PDA). We aimed to assess physicians' perceptions concerning the use of a PDA. METHODS: In a mixed methods study, urologists, gynecologists and general practitioners in the Netherlands were asked to fill out a web-based questionnaire. Questions were based on the Tailored Implementation for Chronic Diseases checklist using the following domains: guideline factors, individual health professional factors, professional interactions, incentives and resources, and capacity for organizational change. Participants were asked to grade statements using a five-point Likert scale and to answer open questions on facilitators of and barriers to implementation of a PDA. Outcomes of statement rating were quantitatively analyzed and thematic analysis was performed on the outcomes regarding facilitators and barriers. RESULTS: The response rate was 11%, with a total of 120 participants completing the questionnaire. Ninety-two of the physicians (77%) would use a PDA in female SUI. Evidence-based and unbiased content, the ability to support shared decision making, and patient empowerment are identified as main facilitators. Barriers are the expected prolonged time investment and the possible difficulty using the PDA in less health-literate patient populations. CONCLUSIONS: The majority of physicians would use a PDA for female SUI. We identified facilitators and barriers that can be used when developing and implementing such a PDA.
INTRODUCTION AND HYPOTHESIS: A treatment choice for female stress urinary incontinence (SUI) is preference sensitive for both patients and physicians. Multiple treatment options are available, with none being superior to any other. The decision-making process can be supported by a patient decision aid (PDA). We aimed to assess physicians' perceptions concerning the use of a PDA. METHODS: In a mixed methods study, urologists, gynecologists and general practitioners in the Netherlands were asked to fill out a web-based questionnaire. Questions were based on the Tailored Implementation for Chronic Diseases checklist using the following domains: guideline factors, individual health professional factors, professional interactions, incentives and resources, and capacity for organizational change. Participants were asked to grade statements using a five-point Likert scale and to answer open questions on facilitators of and barriers to implementation of a PDA. Outcomes of statement rating were quantitatively analyzed and thematic analysis was performed on the outcomes regarding facilitators and barriers. RESULTS: The response rate was 11%, with a total of 120 participants completing the questionnaire. Ninety-two of the physicians (77%) would use a PDA in female SUI. Evidence-based and unbiased content, the ability to support shared decision making, and patient empowerment are identified as main facilitators. Barriers are the expected prolonged time investment and the possible difficulty using the PDA in less health-literate patient populations. CONCLUSIONS: The majority of physicians would use a PDA for female SUI. We identified facilitators and barriers that can be used when developing and implementing such a PDA.
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