The role of a novel decision aid to support informed decision making process in patients with a symptomatic non – lower pole renal stone < 20 mm in diameter: a prospective randomized study

Vol. 45 (5): 941-947, September – October, 2019

doi: 10.1590/S1677-5538.IBJU.2018.0198


ORIGINAL ARTICLE

Mehmet İlker Gokce 1, Cağrı Akpınar 1, Barış Esen 1, Vahid Solak 1, Omer Gülpınar 1, Yaşar Bedük 1
1 Department of Urology, Ankara University School of Medicine, Ankara, Turkey

ABSTRACT

Objectives: To evaluate the efficacy of a novel decision aid (DA) in improving the patients’ level of knowledge and decreasing decisional conflicts while deciding for SWL vs. RIRS in case of a symptomatic renal stone <2 cm.

Materials and Methods: In this prospective randomized study patients were randomized to receive either standard informing process (group 1, n=57) or DA (group 2, n=58). Level of knowledge was assessed with a questionnaire of 10 questions before and after patient informing process. Level of decisional conflict was assessed with a previously validated scoring system. Logistic regression analysis was performed to identify factors associated with adequate level of knowledge.

Results: Level of knowledge increased significantly in both groups after patient informing process. The increase was significantly more prominent in group 2 (p=0.045). Percentage of patients with adequate knowledge was also higher in group 2 (56.1%vs.74.1%, p=0.04). Mean decisional conflict scale score (higher score indicates higher decisional conflict level) was also significantly higher in group1 (14.7±14.5 vs. 10.1±13.7, p=0.045). Multivariate logistic regression analysis revealed higher education level (college degree) and use of DA as factors associated with adequate level of knowledge.

Conclusions: In the current study, The DA was shown to have a positive impact on level of knowledge and diminish the level of decisional conflict for patients with a symptomatic non-lower pole renal stone <20 mm. We recommend development and use of DAs for particular clinic scenarios to aid in education of patients and shared decision making process in stone disease clinics.

 

Keywords: Kidney Calculi; Disease; Lithotripsy

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