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059 The influence of patient characteristics on treatment decision in pelvic organ prolapse – data from the shade-pop trial
  1. Larissa E Drost1,
  2. RDM DE Jong2,
  3. M Stegeman2,
  4. A Franx1,
  5. MC Vos2
  1. 1Obstetrics and Gynecology, Erasmus MC, Rotterdam, The Netherlands
  2. 2Obstetrics and Gynecology, Elisabeth Tweesteden Hospital, Tilburg, The Netherlands


Introduction Women with pelvic organ prolapse (POP) are facing the choice between several treatment options and a potentially difficult decision. Treatment choice may depend on patient characteristics and preferences. The aim of this study was to examine the effect of decisional conflict and patient characteristics on treatment choice in women with POP.

Methods Data from the SHADE-POP trial were used. In all participants, demographic characteristics and validated questionnaires concerning decisional conflict, shared decision making, information provision, anxiety and depression and satisfaction with care were collected. Analyses were performed using univariate and multivariate linear and logistic regression analyses.

Results 96 women with POP facing a treatment decision were included in this study. An increase in decisional conflict as experienced by patients was related to the choice of more conservative treatment, such as pelvic floor muscle training or pessary, instead of surgery (p=0.02). Shared decision making and better information provision were related to lower levels of decisional conflict (p=0.001).

Discussion It is known that many patients with different health conditions can experience decisional conflict. However, we are the first to show that women with POP experience decisional conflict. Gaining knowledge on decisional conflict and the effects of patient characteristics on treatment choice will help clinicians to support patients in the decisional process. This will be a step towards a better guided treatment decision which can result in increased treatment adherence and better patient reported outcomes.

Conclusion Decisional conflict in women with POP favors conservative treatment instead of POP surgery. No effect of other patient characteristics such as age, educational level or decision aid use was found.

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