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

• Published in: Patient education and counseling Vol. 115; p. 107907
• Main Authors: van Delft, Lieke C.J., Essers, Brigitte A.B., Nelemans, Patty J., Mosterd, Klara, van Winden, Marieke E.C., Romaen, Ine F.L., Retra, Sean J.J., Arits, Aimee H.M.M., Steijlen, Peter M., Lubeek, Satish F.K., Kelleners-Smeets, Nicole W.J.
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.10.2023
• Subjects: Basal cell carcinoma; Patient decision aid; Patient education; Shared decision making; Treatment; PDT; Patient education; Patient decision aid; Basal cell carcinoma; Treatment; 5FU; DCS; Shared decision making; sBCC; PDA
• ISSN: 0738-3991; 1873-5134
• DOI: 10.1016/j.pec.2023.107907

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. 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. 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. Using the PDA had no significant effect on decisional conflict levels, but increased overall knowledge on relevant issues concerning sBCC. The PDA can be used as an informational tool by patients with sBCC. •Using a patient decision aid did not have a significant impact on mean decisional conflict levels.•Patients who used a patient decision aid had improved knowledge on relevant issues concerning superficial basal cell carcinoma.•Patients’ need for information was probably met after using the patient decision aid.