Impact of a shared decision-making program on patients with benign prostatic hyperplasia

Objectives. To determine patient views about the Shared Decision-Making Pro gram (SDP), an interactive videodisk program designed to inform patients wi th benign prostatic hyperplasia (BPH) about their condition and treatment o ptions and to determine its impact on perceived knowledge and treatment pre ference. Methods. Six hundred seventy-eight patients with symptomatic BPH from eight Canadian centers viewed the SDP. Before and after viewing the video, patie nts answered questionnaires designed to assess treatment preference, knowle dge gained, and satisfaction with this educational format. A 1-year follow- up survey was also conducted. Results. Most patients showed a high desire for information and high satisf action with the SDP; this satisfaction persisted at 1 year. Patients' self- reported knowledge increased significantly (P <0.0001). However, the SDP di d not alter initial treatment preferences among those with already formed p references, although it aided almost half of those initially undecided in f orming a preference. Viewing the SDP also appeared to enhance the physician -patient relationship. Conclusions. Patients saw the SDP as an effective method for teaching patie nts about BPH and the risks and benefits of various treatments, clarifying particular areas about which many patients appear to have a desire for more information than is often provided. Patients were enthusiastic about the e ducational value of the program, and their active participation in the deci sion-making process may actually enhance the physician-patient relationship . Contrary to other studies, we found no significant alterations in treatme nt preferences. Problems relating to the cost and timely updating of the so ftware need to be addressed for these kinds of programs to realize their fu ll potential. UROLOGY 53: 913-920, 1999. (C) 1999, Elsevier Science Inc. Ai l rights reserved.