Effectiveness of a patient decision aid for patients with superficial basal cell carcinoma: A pre- and post-implementation study

Lieke C J van Delft; Brigitte A B Essers; Patty J Nelemans; Klara Mosterd; Marieke E C van Winden; Ine F L Romaen; Sean J J Retra; Aimee H M M Arits; Peter M Steijlen; Satish F K Lubeek; Nicole W J Kelleners-Smeets

doi:10.1016/j.pec.2023.107907

Effectiveness of a patient decision aid for patients with superficial basal cell carcinoma: A pre- and post-implementation study

Patient Educ Couns. 2023 Oct:115:107907. doi: 10.1016/j.pec.2023.107907. Epub 2023 Jul 20.

Affiliations

¹ Department of Dermatology, Maastricht University Medical Center+, Maastricht, the Netherlands; GROW School for Oncology and Reproduction, Maastricht University, the Netherlands. Electronic address: lieke.van.delft@mumc.nl.
² Department of Clinical Epidemiology & Medical Technology Assessment, Maastricht University Medical Center+, Maastricht, the Netherlands.
³ Department of Epidemiology, Maastricht University, Maastricht, the Netherlands.
⁴ Department of Dermatology, Maastricht University Medical Center+, Maastricht, the Netherlands; GROW School for Oncology and Reproduction, Maastricht University, the Netherlands.
⁵ Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands.
⁶ Department of Dermatology, Maastricht University Medical Center+, Maastricht, the Netherlands; Department of Dermatology, Catharina Hospital, Eindhoven, the Netherlands.

PMID: 37487347
DOI: 10.1016/j.pec.2023.107907

Abstract

Objective: This study evaluates whether using a patient decision aid (PDA) for patients with superficial basal-cell carcinoma (sBCC) results in a decreased decisional conflict level and increased knowledge.

Methods: In a prospective multicentre study, patient groups were included before and after implementation of a PDA. Decisional conflict levels were compared directly after making the treatment decision, measured once as the mean score on the decisional conflict scale (DCS). Higher scores correspond with higher conflict levels (0-100). Secondary outcomes were knowledge on treatment options, recognizing a BCC, and risk factors for developing a BCC measured on an adapted version of a validated knowledge questionnaire for melanoma patients, and patient satisfaction with the PDA.

Results: Data was available for 103 patients in the control-group and 109 in the PDA-group. The mean DCS score in the control-group was 22.78 (SD 14.76) compared to 22.34 (SD 14.54) in the PDA-group; the decrease was non-significant (p = 0.828). The average percentage correct answers on the knowledge questionnaire increased from 76.5% in the control-group to 80.5% in the PDA-group (p = 0.044). According to the majority of patients in the PDA-group (73.7%) the PDA had added value.

Conclusion: Using the PDA had no significant effect on decisional conflict levels, but increased overall knowledge on relevant issues concerning sBCC.

Practice implications: The PDA can be used as an informational tool by patients with sBCC.

Keywords: Basal cell carcinoma; Patient decision aid; Patient education; Shared decision making; Treatment.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Carcinoma, Basal Cell* / therapy
Decision Making
Decision Support Techniques
Humans
Patient Satisfaction
Prospective Studies
Skin Neoplasms* / therapy