4.5 Article

A decision aid to facilitate informed choices among cataract patients: A randomized controlled trial

Journal

PATIENT EDUCATION AND COUNSELING
Volume 104, Issue 6, Pages 1295-1303

Publisher

ELSEVIER IRELAND LTD
DOI: 10.1016/j.pec.2020.10.036

Keywords

Cataract; Cataract surgery; Informed choice; Decision aid

Funding

  1. Construction Project of High-Level Hospitals in Guangdong Province [303020107, 303010303058]
  2. National Natural Science Foundation of China [81530028, 81721003]
  3. Clinical Innovation Research Program of Guangzhou Regenerative Medicine and Health Guangdong Laboratory [2018GZR0201001]
  4. Local Innovative and Research Teams Project of Guangdong Pearl River Talents Program
  5. State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University
  6. Ulverscroft Foundation (UK)

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The study found that using a patient decision aid can increase the proportion of patients making informed choices, improve their overall knowledge about cataract surgery, and reduce the intention to undergo surgery.
Objective: To assess the effect of a patient decision aid on the quality of decision-making for patients with age-related cataracts. Methods: 773 patients with cataracts aged 50-80 years were randomly assigned to receive either the intervention decision aid (including standard information, quantitative information on the possible outcomes of cataract surgery and a value clarification exercise) or the control booklet (including standard information). The primary outcome was informed choice (defined as adequate knowledge and congruency between attitudes and surgical intentions), which was assessed at 2 weeks after intervention via a telephone interview. Results: The decision aid increased the proportion of participants making an informed choice, from 5.68 % in the control group to 27.7 % in the intervention group (P < 0.001). Compared with controls, more participants in the intervention group had adequate overall knowledge about cataract surgery (36.8 % vs. 8.79 % in controls; P < 0.001), and fewer participants intended to undergo surgery (22.5 % vs. 34.1 % in controls; P < 0.001). Conclusion: Use of the patient decision aid may increase the proportion of patients making informed choices. Importantly, it might also reduce the acceptance of operations. Practice implications: Patient decision aids represent a simple and low-cost tool to facilitate informed choice among patients with cataracts. (c) 2020 Elsevier B.V. All rights reserved.

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