Variation in Provider Practice Patterns and the Perceived Need for a Shared Decision-making Tool for Neurogenic Lower...

Area of Science:

• Urology
• Neuroscience
• Patient Care

Background:

• Neurogenic lower urinary tract dysfunction (NLUTD) management is complex and patient-specific.
• Existing care patterns may not align with guidelines or patient outcomes.

Purpose of the Study:

• To assess current practice patterns of NLUTD care providers.
• To evaluate the perceived need for and willingness to use a shared decision-making tool for NLUTD management.

Main Methods:

• An electronic survey was distributed to NLUTD care providers.
• The survey assessed practice patterns, need for, and willingness to use a decision aid.
• Expert NLUTD care providers reviewed the survey prior to dissemination.

Main Results:

• 117 NLUTD care providers participated, primarily urologists.
• Common treatments included sling procedures for stress urinary incontinence and anticholinergics for detrusor overactivity.
• Providers recognized the patient-specific nature of NLUTD and the benefits of clean intermittent catheterization over indwelling catheters for quality of life.

Conclusions:

• Discordances exist between guidelines, practice, and patient outcomes.
• A decision aid is needed to enhance patient-provider communication and shared decision-making in NLUTD care.