Evaluating preference-sensitive care for uterine fibroids: it's not so simple.

Area of Science:

• Medical decision-making
• Patient-centered care
• Gynecological health

Background:

• Preference-sensitive care requires informed patient choices.
• Uterine fibroids are benign with diverse treatment options.
• Evaluating decision-preference concordance is crucial.

Purpose of the Study:

• To assess the measurability of patient preferences in fibroid treatment decisions.
• To evaluate the concordance between patient preferences and chosen treatments.
• To explore the role of patient knowledge in this concordance.

Main Methods:

• Retrospective survey of 260 women with uterine fibroids.
• Survey developed via physician focus groups and patient interviews.
• Correlational analysis of preferences, knowledge, and treatment decisions.

Main Results:

• High patient desire for shared or controlled decision-making (82% response rate).
• Most patients (86%) felt informed and decisions aligned with values.
• Significant correlations found between symptom relief desires and hysterectomy use.
• Knowledge gaps existed; only 55% answered >5/7 fibroid questions correctly.
• Higher patient knowledge correlated with stronger belief in decision-preference concordance (94.9% vs. 74.4%).

Conclusions:

• Knowledge gaps were present, but association with decision-preference concordance was unclear.
• Many women with fibroids felt their treatment decisions reflected their values.
• Further research, including prospective trials, is needed to improve information and counseling for better concordance.