Randomised controlled trial of an interactive multimedia decision aid on benign prostatic hypertrophy in primary care.
OBJECTIVE
To determine whether a decision aid on benign prostatic hypertrophy influences decision making, health outcomes, and resource use.


METHODS
Randomised controlled trial.


METHODS
33 general practices in the United Kingdom.


METHODS
112 men with benign prostatic hypertrophy.


METHODS
Patients' decision aid consisting of an interactive multimedia programme with booklet and printed summary.


METHODS
Patients' and general practitioners' perceptions of who made the decision, decisional conflict scores, treatment choice and prostatectomy rate, American Urological Association symptom scale, costs, anxiety, utility, and general health status.


RESULTS
Both patients and general practitioners found the decision aid acceptable. A higher proportion of patients (32% v 4%; mean difference 28%, 95% confidence interval 14% to 41%) and their general practitioners (46% v 25%; 21%, 3% to 40%) perceived that treatment decisions had been made mainly or only by patients in the intervention group compared with the control group. Patients in the intervention group had significantly lower decisional conflict scores than those in the control group at three months (2.3 v 2.6; -0.3, -0.5 to -0.1, P<0.01) and this was maintained at nine months. No differences were found between the groups for anxiety, general health status, prostatic symptoms, utility, or costs (excluding costs associated with the video disc equipment).


CONCLUSIONS
The decision aid reduced decisional conflict in men with benign prostatic hypertrophy, and the patients played a more active part in decision making. Such programmes could be delivered cheaply by the internet, and there are good arguments for coordinated investment in them, particularly for conditions in which patient utilities are important.
Murray
E
E
Department of Primary Care and Population Sciences, Royal Free and University College Medical School, University College London, London N19 3UA.
Davis
H
H
Tai
S S
SS
Coulter
A
A
Gray
A
A
Haines
A
A
D000368:Aged; D001007:Anxiety / Q000209:etiology; D003658:Decision Making, Computer-Assisted; D005194:Family Practice / Q000379:methods; D005500:Follow-Up Studies; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D019212:Multimedia; D010353:Patient Education as Topic / Q000379:methods; D010358:Patient Participation / Q000191:economics / Q000379:methods*; D017060:Patient Satisfaction; D011320:Primary Health Care / Q000379:methods*; D011470:Prostatic Hyperplasia / Q000523:psychology / Q000628:therapy*