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171 A systematic review of shared decision-making in hyperbaric oxygen treatment
  1. Joost R Meijering1,
  2. Nurseda Risvanoglu2,
  3. Rob AVan Hulst2,
  4. Dirk T Ubbink1
  1. 1Surgery, Amsterdam UMC, Amsterdam, the Netherlands
  2. 2Anaesthesiology, Amsterdam UMC, Amsterdam, the Netherlands


Introduction Hyperbaric Oxygen Therapy (HBOT) is a treatment modality used for various (ischaemic) medical conditions, ranging from ischaemic diabetic ulcers to long-term post-radiation damage. It is administered in 2-hour treatment sessions for 4 to 8 weeks. Although it has a wide application palette, HBOT is also known for being time-consuming and cumbersome for patients, with varying treatment results and substantial drop-out rates. Therefore, SDM seems the obvious approach with patients for whom HBOT is considered. This systematic review was conducted to present the currently available evidence on the extent of SDM in patients eligible for HBOT.

Methods A sensitive literature search was conducted to find all studies with any study design on the level of SDM when considering HBOT as a treatment option. The search was conducted in the Medline and Embase databases and the Cochrane Central Register of Controlled Trials from inception to July 2023. Study selection was conducted by two reviewers independently. Desired outcomes were the introduction, implementation, or observed level of SDM.

Results The search yielded 614 articles, of which 24 full papers were screened for eligibility. After assessment of these articles, 0 remained for inclusion and data extraction, since none of these reported on patient involvement in the decision-making process when considering HBOT. Several articles did mention that SDM should be an important element when developing clinical practice guidelines for HBOT.

Discussion At present no scientific evidence is available regarding (the implementation of) SDM in patients suitable for HBOT.

Conclusion SDM is not reported in literature when considering HBOT, although decision-making for this treatment seems particularly suitable for this approach. Possibly, physicians and patients frequently regard HBOT as a last-resort option that should be tried, or as the only treatment option for specific indications.

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