A study protocol of the effectiveness of PEGASUS: a multi-centred study comparing an intervention to promote shared decision making about breast reconstruction with treatment as usual

BMC Medical Informatics and Decision Making

Study Protocol

Paul White¹  Diana Harcourt²  Nicole Paraskeva²  Alex Clarke²  Jane Powell³ 

[1] Department of Engineering Design & Mathematics, Faculty of Environment & Technology, University of the West of England, BS16 1QY, Bristol, UK;Department of Health & Social Sciences, Centre for Appearance Research, Faculty of Health & Applied Sciences University of the West of England, Coldharbour Lane, BS16 1QY, Bristol, UK;Public Health and Well Being Research Group, Department of Health & Social Sciences, Faculty of Health & Applied Sciences University of the West of England, BS16 1QY, Bristol, UK;

关键词: Pegasus;    Breast reconstruction;    Shared decision making;    Breast cancer;    Mastectomy;    Risk reducing mastectomy;    Ductal carcinoma in situ (DCIS);   

DOI  :  10.1186/s12911-017-0543-0

 received in 2017-08-04, accepted in 2017-09-18,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundIncreasingly, women elect breast reconstruction after mastectomy. However, their expectations of surgery are often not met, and dissatisfaction with outcome and ongoing psychosocial concerns and distress are common. We developed a patient-centered intervention, PEGASUS:(Patients’ Expectations and Goals: Assisting Shared Understanding of Surgery) which supports shared decision making by helping women clarify their own, individual goals about reconstruction so that they can discuss these with their surgeon. Our acceptability/feasibility work has shown it is well received by patients and health professionals alike. We now need to establish whether PEGASUS improves patients’ experiences of breast reconstruction decision making and outcomes. The purpose of this study is, therefore, to examine the effectiveness of PEGASUS, an intervention designed to support shared decision making about breast reconstruction.MethodsA multi-centered sequential study will compare the impact of PEGASUS with usual care, in terms of patient reported outcomes (self-reported satisfaction with the outcome of surgery, involvement in decision making and in the consultation) and health economics. Initially we will collect data from our comparison (usual care) group (90 women) who will complete standardized measures (Breast-Q, EQ5D -5 L and ICECAP- A) at the time of decision making, 3, 6 and 12 months after surgery. Health professionals will then be trained to use PEGASUS, which will be delivered to the intervention group (another 90 women completing the same measures at the time of decision making, and 3, 6 and 12 months after surgery). Health professionals and a purposefully selected sample of participants will be interviewed about whether their expectations of reconstruction were met, and their experiences of PEGASUS (if appropriate).DiscussionPEGASUS may have the potential to provide health professionals with an easily accessible tool aiming to support shared decision making and improve patients’ satisfaction with breast reconstruction. Results of this study will be available at the end of 2019.Trial registrationISRCTN 18000391 (DOI 10.1186/ISRCTN18000391) 27/01/2016.

【 授权许可】

CC BY   
© The Author(s). 2017