Prolapse Treatment-Related Decisional Conflict After New Patient Visits

Area of Science:

• Urogynecology and Pelvic Floor Disorders
• Health Disparities in Healthcare
• Patient Decision-Making and Health Outcomes

Background:

• Pelvic organ prolapse (POP) treatment decisions involve complex factors influencing patient confidence.
• Decisional conflict, a measure of decision-making uncertainty, is crucial for effective treatment selection.
• Understanding decisional conflict in underrepresented patient populations is vital for equitable care.

Purpose of the Study:

• To compare decisional conflict levels between underrepresented patients (URPs) and non-URPs after initial consultations for POP management.
• To identify potential disparities in decision-making comfort related to POP treatments among diverse patient groups.

Main Methods:

• A multicenter cohort study involving 207 new patients counseled on POP management between July 2021 and December 2022.
• Participants completed the validated Decisional Conflict Scale (DCS) to assess decision-making comfort.
• URPs were defined by self-identification as non-White or Hispanic; statistical analysis used an alpha of 0.05.

Main Results:

• No significant difference was found in mean DCS scores between URPs (12.9 ± 12.3) and non-URPs (11.6 ± 14.9; P = 0.31).
• URPs were more likely to have hypertension, while non-URPs had higher rates of prior hysterectomy and prolapse surgery.
• No differences were observed in other pelvic floor disorders, prolapse stage, or selected treatments between the groups.

Conclusions:

• Decisional conflict regarding POP treatments did not differ significantly between underrepresented and non-underrepresented patients.
• Further investigation into potential decisional conflict variations within specific subgroups is warranted.
• Ensuring equitable decision-making support for all patients undergoing POP treatment remains a priority.