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Open Access 01-09-2019 | Inguinal Hernia | Original Scientific Report

Reduced Elective Operation Rates and High Patient Satisfaction After the Implementation of Decision Aids in Patients with Gallstones or an Inguinal Hernia

Authors: Carmen S. S. Latenstein, Bob J. van Wely, Mieke Klerkx, Marjan J. Meinders, Bastiaan Thomeer, Philip R. de Reuver

Published in: World Journal of Surgery | Issue 9/2019

Abstract

Background

For both gallbladder removal and inguinal hernia repair, it is important to include patients’ perspective in the decision-making process, as watchful waiting is an accepted alternative in selected patients. The aim of this study was to evaluate operation rates before and after implementation of decision aids (DAs) and to assess patient compliance with the use of DAs.

Methods

A single-centered retrospective study was performed, including all patients ≥18 years referred to the surgical outpatient clinic with symptomatic gallstones or an inguinal hernia between January 2014 and December 2017. Operation rates before and after implementation of DAs (December 2015) were compared. In addition, patient compliance with the use of DAs and satisfaction with final treatment were assessed.

Results

Overall, 1625 patients with gallstones and 1798 patients with an inguinal hernia were included. After implementation, DAs were provided to 512 patients (63.1%) with gallstones of whom 80.7% (413/512) used the DA and to 528 patients (58.8%) with an inguinal hernia, which was used by 80.7% (426/528). Before implementation, the operation rate in patients with gallstones was 72.0% (586/814) and after implementation 56.7% (460/811) (− 15.3%, p < 0.001). The operation rate in patients with an inguinal hernia decreased from 77.8% (700/900) to 64.6% (580/898) (− 13.2%, p < 0.001). Patient satisfaction with final treatment was high (9/10).

Conclusion

Implementation of DAs in the surgical outpatient clinic for patients with gallstones or an inguinal hernia is associated with reduced elective operation rates and is associated with high DA compliance.

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Russo MW, Wei JT, Thiny MT et al (2004) Digestive and liver diseases statistics, 2004. Gastroenterology 126:1448–1453CrossRefPubMed

Schumpelick V, Treutner KH, Arlt G (1994) Inguinal hernia repair in adults. Lancet (London, England) 344:375–379CrossRef

Jatzko GR, Lisborg PH, Pertl AM et al (1995) Multivariate comparison of complications after laparoscopic cholecystectomy and open cholecystectomy. Ann Surg 221:381–386CrossRefPubMedPubMedCentral

Felix EL, Harbertson N, Vartanian S (1999) Laparoscopic hernioplasty: significant complications. Surg Endosc 13:328–331CrossRefPubMed

Fitzgibbons RJ Jr, Camps J, Cornet DA et al (1995) Laparoscopic inguinal herniorrhaphy. Results of a multicenter trial. Ann Surg 221:3–13CrossRefPubMedPubMedCentral

Phillips EH, Arregui M, Carroll BJ et al (1995) Incidence of complications following laparoscopic hernioplasty. Surg Endosc 9:16–21PubMed

de Goede B, Wijsmuller AR, van Ramshorst GH et al (2018) Watchful waiting versus surgery of mildly symptomatic or asymptomatic inguinal hernia in men aged 50 years and older: a randomized controlled trial. Ann Surg 267:42–49CrossRefPubMed

Vetrhus M, Soreide O, Eide GE et al (2004) Pain and quality of life in patients with symptomatic, non-complicated gallbladder stones: results of a randomized controlled trial. Scand J Gastroenterol 39:270–276CrossRefPubMed

Oliver MN (2003) Watchful waiting is reasonable for gallstone symptoms. The Journal of family practice 52:18–20PubMed

10.

McSherry CK, Ferstenberg H, Calhoun WF et al (1985) The natural history of diagnosed gallstone disease in symptomatic and asymptomatic patients. Ann Surg 202:59–63CrossRefPubMedPubMedCentral

11.

Fitzgibbons RJ, Jonasson O, Gibbs J et al (2003) The development of a clinical trial to determine if watchful waiting is an acceptable alternative to routine herniorrhaphy for patients with minimal or no hernia symptoms. J Am Coll Surg 196:737–742CrossRefPubMed

12.

Jenkins JT, O’Dwyer PJ (2008) Inguinal hernias. BMJ: Bt Med J 336:269–272CrossRef

13.

Friedman GD (1993) Natural history of asymptomatic and symptomatic gallstones. Am J Surg 165:399–404CrossRefPubMed

14.

Halldestam I, Enell E-L, Kullman E et al (2004) Development of symptoms and complications in individuals with asymptomatic gallstones. BJS 91:734–738CrossRef

15.

Uldry E, Schafer M, Saadi A et al (2013) Patients’ preferences on information and involvement in decision making for gastrointestinal surgery. World J Surg 37:2162–2171. https://doi.org/10.1007/s00268-013-2084-8 CrossRefPubMed

16.

Elwyn G, Frosch D, Thomson R et al (2012) Shared decision making: a model for clinical practice. J Gen Intern Med 27:1361–1367CrossRefPubMedPubMedCentral

17.

Barratt A (2008) Evidence based medicine and shared decision making: the challenge of getting both evidence and preferences into health care. Patient Educ Couns 73:407–412CrossRefPubMed

18.

Ubbink DT, Hageman MG, Legemate DA (2015) Shared decision-making in surgery. Surg Technol Int 26:31–36PubMed

19.

de Mik SML, Stubenrouch FE, Balm R et al (2018) Systematic review of shared decision-making in surgery. BJS 105:1721–1730CrossRef

20.

Stacey D, Legare F, Lewis K et al (2017) Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev 4:CD001431

21.

Stiggelbout AM, Pieterse AH, De Haes JC (2015) Shared decision making: concepts, evidence, and practice. Patient Educ Couns 98:1172–1179CrossRefPubMed

22.

Knops AM, Legemate DA, Goossens A et al (2013) Decision aids for patients facing a surgical treatment decision: a systematic review and meta-analysis. Ann Surg 257:860–866CrossRefPubMed

23.

Vandenbroucke JP, von Elm E, Altman DG et al (2014) Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. Int J Surg (London, England) 12:1500–1524CrossRef

24.

Jensen MP, Chen C, Brugger AM (2003) Interpretation of visual analog scale ratings and change scores: a reanalysis of two clinical trials of postoperative pain. J Pain: Off J Am Pain Soc 4:407–414CrossRef

25.

de Reuver PR, van Dijk AH, Wennmacker SZ et al (2016) A randomized controlled trial to compare a restrictive strategy to usual care for the effectiveness of cholecystectomy in patients with symptomatic gallstones (SECURE trial protocol). BMC Surg 16:46CrossRefPubMedPubMedCentral

26.

Arterburn D, Wellman R, Westbrook E et al (2012) Introducing decision aids at Group Health was linked to sharply lower hip and knee surgery rates and costs. Health Aff (Millwood) 31:2094–2104CrossRef

27.

Deyo RA, Cherkin DC, Weinstein J et al (2000) Involving patients in clinical decisions: impact of an interactive video program on use of back surgery. Med Care 38:959–969CrossRefPubMed

28.

Kennedy AD, Sculpher MJ, Coulter A et al (2002) Effects of decision aids for menorrhagia on treatment choices, health outcomes, and costs: a randomized controlled trial. JAMA 288:2701–2708CrossRefPubMed

29.

Molenaar S, Sprangers MA, Rutgers EJ et al (2001) Decision support for patients with early-stage breast cancer: effects of an interactive breast cancer CDROM on treatment decision, satisfaction, and quality of life. J Clin Oncol 19:1676–1687CrossRefPubMed

30.

Auvinen A, Hakama M, Ala-Opas M et al (2004) A randomized trial of choice of treatment in prostate cancer: the effect of intervention on the treatment chosen. BJU Int 93:52–56 discussion 56 CrossRefPubMed

31.

Whelan T, Levine M, Willan A et al (2004) Effect of a decision aid on knowledge and treatment decision making for breast cancer surgery: a randomized trial. JAMA 292:435–441CrossRefPubMed

32.

Vandemheen KL, O’Connor A, Bell SC et al (2009) Randomized trial of a decision aid for patients with cystic fibrosis considering lung transplantation. Am J Respir Crit Care Med 180:761–768CrossRefPubMed

33.

Vodermaier A, Caspari C, Koehm J et al (2009) Contextual factors in shared decision making: a randomised controlled trial in women with a strong suspicion of breast cancer. Br J Cancer 100:590–597CrossRefPubMedPubMedCentral

34.

Boss EF, Mehta N, Nagarajan N et al (2016) Shared decision-making and choice for elective surgical care: A systematic review. Otolaryngol Head Neck Surg 154:405–420CrossRefPubMed

35.

Lamberts MP, Lugtenberg M, Rovers MM et al (2013) Persistent and de novo symptoms after cholecystectomy: a systematic review of cholecystectomy effectiveness. Surg Endosc 27:709–718CrossRefPubMed

36.

Wennmacker S, Lamberts M, Gerritsen J et al (2017) Consistency of patient-reported outcomes after cholecystectomy and their implications on current surgical practice: a prospective multicenter cohort study. Surg Endosc 31:215–224CrossRef

37.

Vetrhus M, Berhane T, Soreide O et al (2005) Pain persists in many patients five years after removal of the gallbladder: observations from two randomized controlled trials of symptomatic, noncomplicated gallstone disease and acute cholecystitis. J Gastrointest Surg 9:826–831CrossRefPubMed

38.

Dutch Health Care Authority (Nederlandse Zorgautoriteit) (2017) DRG Database (Open DIS data)

Title: Reduced Elective Operation Rates and High Patient Satisfaction After the Implementation of Decision Aids in Patients with Gallstones or an Inguinal Hernia
Authors: Carmen S. S. Latenstein
Bob J. van Wely
Mieke Klerkx
Marjan J. Meinders
Bastiaan Thomeer
Philip R. de Reuver
Publication date: 01-09-2019
Publisher: Springer International Publishing
Keyword: Inguinal Hernia
Published in: World Journal of Surgery / Issue 9/2019
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-019-05007-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Reduced Elective Operation Rates and High Patient Satisfaction After the Implementation of Decision Aids in Patients with Gallstones or an Inguinal Hernia

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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