A Novel Decision Aid for Colectomy in Diverticulitis: Cluster Randomized Pilot and Feasibility Study

Area of Science:

• Colorectal Surgery
• Patient-Centered Care
• Health Informatics

Background:

• Shared decision-making is vital for recurrent diverticulitis treatment, balancing medical and surgical options with patient preferences.
• Effective decision-making tools are needed to support patients in complex treatment choices.

Purpose of the Study:

• To assess the feasibility of a pre-visit online diverticulitis decision aid.
• To evaluate the impact of the decision aid on patient-centered outcomes, specifically decisional conflict.

Main Methods:

• A cluster randomized pilot trial was conducted at a single tertiary care center.
• Patients with recurrent diverticulitis were randomized to use an online Diverticulitis Decision Aid or receive usual care.
• The primary outcome was decisional conflict, with secondary outcomes including decision regret and shared decision-making quality.

Main Results:

• 31 patients were enrolled (15 control, 16 intervention) in the pilot trial.
• Baseline decisional conflict scores were high (median 48.4).
• The decision aid group showed a significantly greater reduction in decisional conflict (median 34.4) compared to the usual care group (median 7.8).

Conclusions:

• Pre-visit online decision aid use is feasible for patients with recurrent diverticulitis.
• The decision aid appears to be more effective than usual care in reducing decisional conflict.
• Further research with longer follow-up is warranted.