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Understanding patients' preferences for surgical management of urethral stricture disease.

Abstract：

OBJECTIVES:To understand how prioritization of treatment attributes and treatment choice varies by patient characteristics, we sought to specifically determine how demographic variables affect patient treatment preference. PATIENTS AND METHODS:Male patients with urethral stricture disease participated in a choice-based conjoint (CBC) analysis exercise evaluating six treatment attributes associated with internal urethrotomy and urethroplasty. Demographic and past symptom data were collected. Stratified analysis of demographic variables, including age, education, income, was conducted using a mixed effect logistic regression model to evaluate the coefficient size and confidence intervals between the treatments attribute preferences of each strata. RESULTS:169 patients completed the CBC exercise and were included in our analysis. Overall success of the procedure is the most important treatment attribute to patients and this persists across strata. Older patients (≥65) express preferences for better success rates and fewer future procedures, whereas younger patients prefer a less invasive approach and are more willing to accept additional procedures if needed. Patients with lower levels of education preferred open reconstruction and had a stronger preference against multiple future procedures, whereas those with higher levels of education preferred endoscopic treatment and had a less strong preference against multiple future procedures. Low-income individuals express statistically significant stronger negative preferences against high copay costs compared to high-income individuals. CONCLUSION:These results can help to inform physicians' counseling about surgical management of urethral stricture disease to better align patient preferences with treatment selection and encourage shared decision making.

journal_name

World J Urol

journal_title

World journal of urology

authors

Hampson LA,Lin TK,Wilson L,Allen IE,Gaither TW,Breyer BN

doi

10.1007/s00345-017-2066-9

subject

Has Abstract

pub_date

2017-11-01 00:00:00

pages

1799-1805

issue

11

eissn

0724-4983

issn

1433-8726

pii

10.1007/s00345-017-2066-9

journal_volume

35

pub_type

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