Shared Decision-Making (SDM) for Female SUI: Current Practice in Three Western Countries.

Area of Science:

• Urology
• Healthcare Decision-Making
• Patient-Centered Care

Background:

• Stress urinary incontinence (SUI) presents multiple treatment options requiring patient counseling.
• Shared decision-making (SDM) is recommended for preference-sensitive decisions, incorporating patient preferences.
• This study investigated the current decision-making process for SUI in Canada, the UK, and the Netherlands.

Purpose of the Study:

• To map the prevailing decision-making styles used in managing stress urinary incontinence.
• To compare patient and physician perceptions of decision-making processes in SUI consultations.
• To evaluate the concordance between preferred and perceived decision-making styles.

Main Methods:

• A multicentre, prospective study involving 124 patients and 18 physicians across five hospitals.
• Utilized Control Preference Scale (CPS) questionnaires for both patients and physicians.
• Assessed the degree of SDM using audio-recordings of consultations analyzed with the OPTION-5 instrument.

Main Results:

• A majority of patients (63%) perceived decision-making as informative, with fewer experiencing it as shared (29%) or paternalistic (8%).
• Dutch patients reported more informative decision-making compared to UK and Canadian patients.
• Patient-preferred and perceived decision-making styles aligned in 70% of cases, but patient-physician perceptions of SDM use showed significant discrepancies, not aligning with OPTION-5 scores.

Conclusions:

• Both patients and physicians generally prefer and perceive current SUI decision-making as informative.
• Discrepancies exist between patient and physician perceptions of their consultations and the application of SDM.
• The concept of SDM appears imprecise for both patients and physicians in the context of SUI management.