PATIENT INFORMATION AND DECISION-MAKING IN CONGENITAL AORTIC AND PULMONARY VALVE SURGERY: PHYSICIAN OPINION

Purpose: To optimize treatment of patients with congenital aortic (AV) and pulmonary valve (PV) disease, informing patients in an objective and understandable manner and involving them in decision-making is increasingly considered to be important. A cross-sectional survey was conducted among physicians to assess the current state of patient information and shared decision-making (SDM) in congenital aortic and pulmonary valve surgery.

Method: A questionnaire concerning patient information and decision-making in congenital aortic and pulmonary valve surgery was sent to all pediatric cardiologists, adult congenital cardiologists and congenital cardiothoracic surgeons in the Netherlands. Survey measures included physician profile and current practice and physician views on patient information and involvement in decision-making.

Result: Thirty-five subjects (14 pediatric cardiologists, 14 adult congenital cardiologists and 7 congenital cardiothoracic surgeons) with a mean age of 36.3±8.7 years and a mean 12.8±8.7 years of experience in their respective specialties were included. Survey results are listed in Figure 1.

Conclusion: Physicians agree that patient information is suboptimal, due in large to limited availability of reliable patient information. Consequently, patients rely heavily on physicians for information, who do not always inform them completely. Physicians also agree that decision-making should be a shared decision process. However, they experience difficulty in involving patients due to limited patient knowledge and comprehension and limited time. Therefore, there is an urgent need for innovative solutions such as online evidence-based patient information portals.

Figure 1. Survey results.