Evaluating Patient Preferences in Benign Prostatic Hyperplasia Treatment Using Conjoint Analysis.

Area of Science:

• Urology
• Patient-centered care
• Health outcomes research

Background:

• Discordance between patient and urologist priorities for benign prostatic hyperplasia (BPH) treatment can hinder patient-centered care and lead to dissatisfaction.
• Physician assumptions about patient preferences may not align with actual patient values, impacting the quality of life outcomes after BPH surgery.
• Current American Urologic Association guidelines recommend considering patient preferences in BPH treatment recommendations.

Purpose of the Study:

• To quantify patient preferences for benign prostatic hyperplasia (BPH) treatments to support guideline-compliant, patient-centered care.
• To identify key attributes influencing patient decision-making in BPH treatment selection.
• To understand how patient preferences vary across different demographic groups, particularly age.

Main Methods:

• A cross-sectional, online survey study was conducted using researchmatch.org.
• Participants engaged in a choice-based conjoint analysis, evaluating theoretical BPH treatments with varying efficacy, recovery difficulty, complication risk (Clavien-Dindo 2+), and ejaculatory dysfunction risk.
• Data analysis included comparative statistics, conditional logit modeling, and calculation of attribute importance.

Main Results:

• Complication risk emerged as the most important attribute influencing BPH treatment decisions, followed by efficacy, recovery difficulty, and ejaculatory dysfunction risk.
• Subgroup analysis revealed that younger participants (<38) prioritized efficacy, while older participants (>67) prioritized complication risk.
• Males generally valued minimizing complication risks, with ejaculatory dysfunction being the least impactful factor.

Conclusions:

• Patient preferences for BPH treatment attributes, particularly complication risk and efficacy, vary significantly based on age.
• Individualized care approaches are necessary to address the diverse preferences within the BPH patient population.
• Aligning treatment decisions with patient-specific priorities is essential for maximizing satisfaction and achieving patient-centered outcomes in BPH management.