Original Title: Herramientas de ayuda para la toma de decisiones de los pacientes con hiperplasia benigna de próstata

Authors' objectives: 1) To conduct an a systematic search for, and create an inventory, all PDST which consider the management choices facing patients who are diagnosed as having benign prostatic hyperplasia (BPH). 2) To complete a systematic review of evaluations of PDST designed for patients with BPH, analyse the outcomes specified, and assess their effectiveness and impact.

Authors' results and conclusions: RESULTS: A total of 153 studies were considered: after the elimination of duplicates, 130 were screened; 56 selected for detailed assessment. Thirteen studies were eventually included: three systematic reviews (Anderson 1997, Estabrooks 2001, O’Connor 2002), two randomized clinical trials (Barry 1997, Murray 2001) and eight more articles (Barry 1995, Shepperd 1995, Wagner 1995, Piercy 1999, Holmes-Rovner 2004, Rovner 2004, Wills 2006, Kelly-Blake 2006) which provided details regarding the outcomes of five observational studies. All included studies used “The Shared Decision-Making Program (SDP)”. This patient decision support technology was developed by the Foundation for Informed Decision Making, Boston (Hanover 1992, 1995, 1999). In the clinical trials (Barry 1997 and Murray 2001), the PDST did not have a significant influence on the decision making process, although the trials report a tendency to increase the preferences of patients for conservative options, such as ‘watch and wait’. In Barry 1997, no difference is reported between PDST groups, however an increase patients’ knowledge, an improvement in the general health status and in the physical function of individuals in the intervention group was observed, but no changes reported for the degree of urinary symptoms. In Murray 2001, however, no differences were observed in general health status, urinary symptoms, or anxiety between control and intervention groups. The observational studies included show similar results to the clinical trials. CONCLUSIONS: PDST increase patients’ knowledge about benign prostatic hyperplasia, and in some individuals demonstrate improved perceptions about their health status. Patients place a high value on PDST because they find them useful when they face decision options. Nevertheless, it is possible to argue that PDST have not been compared with patient information formatswhich might achieve the same objectives with less costs. The influence of the PDST on decisions made by patients and on the therapeutic option eventually followed is not clear cut, and there are only a few high quality studies available. The implementation of PDST is likely to be limited, partly because of cost and partly because their utility in healthcare contexts is still debated. There is therefore a need to study the impact of these technologies in more detail, to consider that their influence could be caused by a range of factors, such as the increased attention to decision making in the clinic and that they are a means of achieving higher patient empowerment and autonomy

Project Status: Completed

Year Published: 2007

URL for published report: https://sescs.es/herramientas-de-ayuda-para-la-toma-de-decisiones-de-los-pacientes/

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Spain

Organisation Name: Canary Health Service

Contact Address: Dirección del Servicio. Servicio Canario de la Salud, Camino Candelaria 44, 1ª planta, 38109 El Rosario, Santa Cruz de Tenerife

Contact Name: sescs@sescs.es

Contact Email: sescs@sescs.es