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Decision Aid Video for Treatment Selection in Latinas With Symptomatic Pelvic Organ Prolapse

A Randomized Pilot Study

Montoya, T. Ignacio, MD; Rondeau, Nancy U., MPH; Maldonado, P. Antonio, MD; Mallett, Veronica T., MD

Female Pelvic Medicine & Reconstructive Surgery: April 17, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/SPV.0000000000000727
Original Article: PDF Only
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Objectives To assess impact of a decision aid video in Latina patients with symptomatic pelvic organ prolapse (POP) on knowledge, satisfaction and decisional conflict related to initial treatment selection.

Methods Pilot study with randomized prospective design. Thirty Latina women with symptomatic POP were randomized to a decision aid intervention plus standard care (N = 15) or standard care alone (N = 15) group. Decision aid intervention consisted of a 10-minute video presented at time of initial evaluation for POP. Outcome measures included the Prolapse and Incontinence Knowledge Quiz (“Knowledge”), the Satisfaction with Decision (“Satisfaction”) and Decisional Conflict (DCS) scales, and were assessed at 4 different timepoints: after initial visit, and at 1, 3 and 6 months after. Data was analyzed using repeated-measures ANOVA and pairwise between-group comparisons.

Results Demographic and baseline data were similar between groups. There was a significant interaction between groups and time on the Knowledge scores (P = 0.03). Knowledge scores were higher at the initial visit in the intervention group (10.6 ± 0.8 vs 9.53 ± 1.4, P = 0.014). Satisfaction scores were lower in the intervention group on longitudinal analysis, indicating higher satisfaction (P = 0.02). There was no difference on overall Decisional Conflict scores between groups. The intervention group had lower scores on the “effective decision” DCS subscale at 3 and 6 months and “informed” DCS subscale at 3 months.

Conclusions A decision aid video intervention in Latina women with POP used at the time of initial evaluation may help the patient make a more informed treatment decision by increasing condition-related knowledge and lead to greater long-term satisfaction.

From the Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center El Paso, El Paso, TX.

Correspondence: T. Ignacio Montoya, MD, Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center El Paso, 4801 Alberta Ave. Suite C250, El Paso, TX 79912. E-mail: teodoro.montoya@ttuhsc.edu.

The authors have declared they have no conflicts of interest.

Supported by Texas Tech University Health Sciences Center El Paso institutional seed grant.

Clinical trial registration: www.clinicaltrials.gov, NCT02850835.

Presented at the 44th Annual Society of Gynecologic Surgeons Scientific Meeting, March 11-14th, 2018, Orlando, FL.

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