Randomized Trial of a Video‐Based Patient Decision Aid for Bariatric Surgery
- 1 August 2011
- Vol. 19 (8), 1669-1675
- https://doi.org/10.1038/oby.2011.65
Abstract
The decision to have bariatric surgery should be based on accurate information on possible risks and benefits of all treatment options. The goal of this study was to determine whether a video-based bariatric decision aid intervention results in superior decision quality compared to an educational booklet. We conducted a prospective, randomized controlled trial among adult patients in a single health plan who met standard criteria for bariatric surgery. Patients were randomly assigned to review either a video-based decision aid (intervention) or an educational booklet on bariatric surgery (control). Changes in patient decision quality were assessed using bariatric-specific measures of knowledge, values, and treatment preference after 3 months. Of 152 eligible participants, 75 were randomly assigned to the intervention and 77 to the control. The 3-month follow-up rate was 95%. Among all participants, significant improvements were observed in knowledge (P < 0.001), values concordance (P = 0.009), decisional conflict (P < 0.001), decisional self-efficacy (P < 0.001), and in the proportion who were "unsure" of their treatment choice (P < 0.001). The intervention group had larger improvements in knowledge (P = 0.03), decisional conflict (P = 0.03), and outcome expectancies (P = 0.001). The proportion of participants choosing bariatric surgery did not differ significantly between groups, although there was a trend toward decreased surgical choice in the intervention group (59% booklet vs. 42% video at 3 months; P = 0.16). The use of bariatric surgery decision aids was followed by improved decision quality and reduced uncertainty about treatment at 3 months. The video-based decision aid appeared to have a greater impact than the educational booklet on patient knowledge, decisional conflict, and outcome expectancies.This publication has 23 references indexed in Scilit:
- Decision aids for people facing health treatment or screening decisionsPublished by Wiley ,2011
- Perioperative Safety in the Longitudinal Assessment of Bariatric SurgeryNew England Journal of Medicine, 2009
- Long-Term Mortality after Gastric Bypass SurgeryNew England Journal of Medicine, 2007
- Effects of Bariatric Surgery on Mortality in Swedish Obese SubjectsNew England Journal of Medicine, 2007
- Toward The ‘Tipping Point’: Decision Aids And Informed Patient ChoiceHealth Affairs, 2007
- Informed Patient Choice: Patient-Centered Valuing Of Surgical Risks And BenefitsHealth Affairs, 2007
- An approach to measuring the quality of breast cancer decisionsPatient Education and Counseling, 2007
- Developing a quality criteria framework for patient decision aids: online international Delphi consensus processBMJ, 2006
- The effects of outcome expectations and satisfaction on weight loss and maintenance: Correlational and experimental analyses-a randomized trial.Health Psychology, 2005
- Modifying Unwarranted Variations In Health Care: Shared Decision Making Using Patient Decision AidsHealth Affairs, 2004