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Testing of a risk-stratified patient decision aid to facilitate shared decision-making for extended postoperative thromboprophylaxis after major abdominal surgery for cancer.
Ivankovic, Victoria; Delisle, Megan; Stacey, Dawn; Abou-Khalil, Jad; Balaa, Fady; Bertens, Kimberly A; Dingley, Brittany; Martel, Guillaume; McAlpine, Kristen; Nessim, Carolyn; Tadros, Shaheer; Carrier, Marc; Auer, Rebecca C.
Affiliation
  • Ivankovic V; From the Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Ivankovic, Delisle, Balaa, Dingley); the School of Nursing, University of Ottawa, Ottawa, Ont. (Stacey); the Ottawa Hospital Research Institute, Ottawa, Ont. (Stacey, Abou-Khalil, Bertens, Martel, Nessim, Tadros, Carrier, Auer); the D
  • Delisle M; From the Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Ivankovic, Delisle, Balaa, Dingley); the School of Nursing, University of Ottawa, Ottawa, Ont. (Stacey); the Ottawa Hospital Research Institute, Ottawa, Ont. (Stacey, Abou-Khalil, Bertens, Martel, Nessim, Tadros, Carrier, Auer); the D
  • Stacey D; From the Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Ivankovic, Delisle, Balaa, Dingley); the School of Nursing, University of Ottawa, Ottawa, Ont. (Stacey); the Ottawa Hospital Research Institute, Ottawa, Ont. (Stacey, Abou-Khalil, Bertens, Martel, Nessim, Tadros, Carrier, Auer); the D
  • Abou-Khalil J; From the Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Ivankovic, Delisle, Balaa, Dingley); the School of Nursing, University of Ottawa, Ottawa, Ont. (Stacey); the Ottawa Hospital Research Institute, Ottawa, Ont. (Stacey, Abou-Khalil, Bertens, Martel, Nessim, Tadros, Carrier, Auer); the D
  • Balaa F; From the Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Ivankovic, Delisle, Balaa, Dingley); the School of Nursing, University of Ottawa, Ottawa, Ont. (Stacey); the Ottawa Hospital Research Institute, Ottawa, Ont. (Stacey, Abou-Khalil, Bertens, Martel, Nessim, Tadros, Carrier, Auer); the D
  • Bertens KA; From the Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Ivankovic, Delisle, Balaa, Dingley); the School of Nursing, University of Ottawa, Ottawa, Ont. (Stacey); the Ottawa Hospital Research Institute, Ottawa, Ont. (Stacey, Abou-Khalil, Bertens, Martel, Nessim, Tadros, Carrier, Auer); the D
  • Dingley B; From the Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Ivankovic, Delisle, Balaa, Dingley); the School of Nursing, University of Ottawa, Ottawa, Ont. (Stacey); the Ottawa Hospital Research Institute, Ottawa, Ont. (Stacey, Abou-Khalil, Bertens, Martel, Nessim, Tadros, Carrier, Auer); the D
  • Martel G; From the Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Ivankovic, Delisle, Balaa, Dingley); the School of Nursing, University of Ottawa, Ottawa, Ont. (Stacey); the Ottawa Hospital Research Institute, Ottawa, Ont. (Stacey, Abou-Khalil, Bertens, Martel, Nessim, Tadros, Carrier, Auer); the D
  • McAlpine K; From the Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Ivankovic, Delisle, Balaa, Dingley); the School of Nursing, University of Ottawa, Ottawa, Ont. (Stacey); the Ottawa Hospital Research Institute, Ottawa, Ont. (Stacey, Abou-Khalil, Bertens, Martel, Nessim, Tadros, Carrier, Auer); the D
  • Nessim C; From the Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Ivankovic, Delisle, Balaa, Dingley); the School of Nursing, University of Ottawa, Ottawa, Ont. (Stacey); the Ottawa Hospital Research Institute, Ottawa, Ont. (Stacey, Abou-Khalil, Bertens, Martel, Nessim, Tadros, Carrier, Auer); the D
  • Tadros S; From the Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Ivankovic, Delisle, Balaa, Dingley); the School of Nursing, University of Ottawa, Ottawa, Ont. (Stacey); the Ottawa Hospital Research Institute, Ottawa, Ont. (Stacey, Abou-Khalil, Bertens, Martel, Nessim, Tadros, Carrier, Auer); the D
  • Carrier M; From the Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Ivankovic, Delisle, Balaa, Dingley); the School of Nursing, University of Ottawa, Ottawa, Ont. (Stacey); the Ottawa Hospital Research Institute, Ottawa, Ont. (Stacey, Abou-Khalil, Bertens, Martel, Nessim, Tadros, Carrier, Auer); the D
  • Auer RC; From the Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Ivankovic, Delisle, Balaa, Dingley); the School of Nursing, University of Ottawa, Ottawa, Ont. (Stacey); the Ottawa Hospital Research Institute, Ottawa, Ont. (Stacey, Abou-Khalil, Bertens, Martel, Nessim, Tadros, Carrier, Auer); the D
Can J Surg ; 67(4): E320-E328, 2024.
Article in En | MEDLINE | ID: mdl-39191449
ABSTRACT

BACKGROUND:

Use of extended pharmacologic thromboprophylaxis after major abdominopelvic cancer surgery should depend on best-available scientific evidence and patients' informed preferences. We developed a risk-stratified patient decision aid to facilitate shared decision-making and sought to evaluate its effect on decision-making quality regarding use of extended thromboprophylaxis.

METHODS:

We enrolled patients undergoing major abdominopelvic cancer surgery at an academic tertiary care centre in this pre-post study. We evaluated change in decisional conflict, readiness to decide, decision-making confidence, and change in patient knowledge. Participants were provided the appropriate risk-stratified decision aid (according to their Caprini score) in either the preoperative or postoperative setting. A sample size calculation determined that we required 17 patients to demonstrate whether the decision aid meaningfully reduced decisional conflict. We used the Wilcoxon matched-pairs signed ranks test for interval scaled measures.

RESULTS:

We included 17 participants. The decision aid significantly reduced decisional conflict (median decisional conflict score 2.37 [range 1.00-3.81] v. 1.3 [range 1.00-3.25], p < 0.01). With the decision aid, participants had high confidence (median 86.4 [range 15.91-100]) and felt highly prepared to make a decision (median 90 [range 55-100]). Median knowledge scores increased from 50% (range 0%-100%) to 75% (range 25%-100%).

CONCLUSION:

Our risk-stratified, evidence-based decision aid on extended thromboprophylaxis after major abdominopelvic surgery significantly improved decision-making quality. Further research is needed to evaluate the usability and feasibility of this decision aid in the perioperative setting.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Decision Support Techniques / Decision Making, Shared Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: En Journal: Can J Surg Year: 2024 Document type: Article Country of publication:
Fulltext
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Decision Support Techniques / Decision Making, Shared Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: En Journal: Can J Surg Year: 2024 Document type: Article Country of publication: