Treatment preferences of patients with benign prostatic hyperplasia before and after using a web-based decision aid.

To evaluate treatment preferences of patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) before and after using a web-based decision aid (DA).

Between July 2016 and January 2017 patients were invited to use a web-based LUTS/BPH DA. Treatment preferences (for lifestyle advices, medication or surgery) before and after DA use and responses on values clarification exercises (VCEs) were extracted from the DA.

In total, 126 patients were included in the analysis. Thirty-four percent (43/126) had not received any previous treatment and were eligible for (continuation of) lifestyle advices or to start medication, as initial treatment. The other sixty-six percent (83/126) did use medication and were eligible, either for continuing medication or to undergo surgery. Before being exposed to the DA, 67 patients (53%) were undecided and 59 patients (47%) indicated an initial treatment preference. Half of the patients who were initially undecided were able to indicate a preference after DA use (34/67, 51%). Of those with an initial preference, 80% (47/59) confirmed their initial preference after DA use. Five out of seven VCEs used in the DA were discriminative between final treatment preferences. In 79%, the treatment preferred after DA use matched the received treatment. Overall, healthcare providers were positive about DA feasibility.

Our findings suggest that a LUTS/BPH DA may help patients to confirm their initial treatment preference and support them in forming a treatment preference if they did not have an initial preference.

Urology. 2019 Dec 30 [Epub ahead of print]

Romy E D Lamers, Fieke C van der Wijden, Isabel B de Angst, Marieke de Vries, Maarten Cuypers, Harm H E van Melick, Jeltje S de Beij, Dennis J A J Oerlemans, Cees van de Beek, Ruud J L H R Bosch, Paul J M Kil

Department of Urology, Elisabeth-Tweesteden Hospital, Hilvarenbeekseweg 60, 5022 GC, Tilburg, the Netherlands. Electronic address: ., Department of Urology, Elisabeth-Tweesteden Hospital, Hilvarenbeekseweg 60, 5022 GC, Tilburg, the Netherlands. Electronic address: ., Department of Urology, Elisabeth-Tweesteden Hospital, Hilvarenbeekseweg 60, 5022 GC, Tilburg, the Netherlands. Electronic address: ., Institute for Computing and Information Sciences (iCIS) & Social and Cultural Psychology, Behavioural Science Institute, Radboud University, Mercator I, Toernooiveld 216, 6525 EC Nijmegen, the Netherlands. Electronic address: ., Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud university medical center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands. Electronic address: ., Department of Urology, St. Antonius Hospital, Koekoekslaan 1, 3435 CM Nieuwegein, the Netherlands. Electronic address: ., Department of Urology, Zuyderland Medical Centre, Henri Dunantstraat 5, 6419 PC Heerlen, the Netherlands., Department of Urology, Laurentius Hospital, Monseigneur Driessenstraat 6, 6043 CV Roermond, the Netherlands. Electronic address: ., Department of Urology, Maastricht UMC+, P. Debyelaan 25, 6229 HX Maastricht, the Netherlands. Electronic address: ., Department of Urology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. Electronic address: ., Department of Urology, Elisabeth-Tweesteden Hospital, Hilvarenbeekseweg 60, 5022 GC, Tilburg, the Netherlands. Electronic address: .