Mp12-20 Development of a Patient-Facing Clinical Decision Support Tool in Kidney Stone Disease: Results From a Qualitative Analysis

You have accessJournal of UrologyHealth Services Research: Practice Patterns, Quality of Life and Shared Decision Making I (MP12)1 May 2024MP12-20 DEVELOPMENT OF A PATIENT-FACING CLINICAL DECISION SUPPORT TOOL IN KIDNEY STONE DISEASE: RESULTS FROM A QUALITATIVE ANALYSIS Kelli R. Aibel, Shannon M. Ervey, Michael Diefenbach, and Jared S. Winoker Kelli R. AibelKelli R. Aibel , Shannon M. ErveyShannon M. Ervey , Michael DiefenbachMichael Diefenbach , and Jared S. WinokerJared S. Winoker View All Author Informationhttps://doi.org/10.1097/01.JU.0001009376.16371.fb.20AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Kidney stones (KS) are a global healthcare concern with over 500,000 Americans seeking treatment annually. The wide range of treatment options necessitates patient education and decision support that is best achieved with a shared decision-making (SDM) approach. While clinicians commonly base treatment discussions on clinical factors and stone characteristics, patients often base their decision on personal values and preferences, which introduces the potential for misalignment in treatment choice. To facilitate SDM in KS patients, we developed the 'Kidney Stone Home (KSH),' a novel, web-based, integrated educational tool and treatment decision-aid. KSH offers information on surveillance and available treatments, surgical and non-surgical, and assists patients in identifying their preferences, sharing results with their physician to guide personalized consultations. METHODS: Prior to website development, we conducted interviews with 11 patients who had recent KS episodes, recruited from a New York City academic center between February to May 2022. Eligible participants were adults≥18 years with a confirmed, non-emergent KS diagnosis. Interviews were conducted by a physician and a behavioral scientist, using an interview guide, assessing prior stone experiences and educational needs. Extensive notes were taken during the interview process, which were coded by two reviewers. Coding discrepancies were resolved through rounds of discussion, resulting in a final codebook, and thematic saturation was achieved with 11 patients. RESULTS: Interviews centered around three major themes: (1) First vs. recurrent kidney stone. For first-time kidney stone patients, detailed information and reliance on the treating urologist was key, while those with recurrent stones focused on satisfaction with prior treatment for decision-making. (2) Pain experience and tolerance. Pain avoidance was a major factor in treatment selection, as all patients expressed fear of the high pain levels associated with KS, and recurrent stone formers of stent-related discomfort. (3) Interpersonal factors guiding treatment selection. Treatment decisions were also influenced by friends, family, and online information searches, with a preference for information endorsed by trusted physicians and personal connections. CONCLUSIONS: Our qualitative study with stakeholders of the future KSH website identified patient informational needs and treatment preferences, informing website and content development. Next, we will conduct a hybrid efficacy and implementation study at various clinic sites to enhance patient knowledge, treatment decisions, and quality of life. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e209 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Kelli R. Aibel More articles by this author Shannon M. Ervey More articles by this author Michael Diefenbach More articles by this author Jared S. Winoker More articles by this author Expand All Advertisement PDF downloadLoading ...