The Effect of a Patient Decision Aid Developed for Chinese Primary Angle Closure Patients: A Randomized Control Trial

Yijie Chen,1 Shaodan Zhang,2 Yiwen Sun,1 Jingyao Dai,1 Yanqian Xie,2 Rongrong Le,2 Shuxia Xu,2 Xiaoxian Zhang,1 Jiali Huang,1 Wenzhe Zhou,2,* Yanyan Chen,3,* Yuanbo Liang2 1School of Ophthalmology and Optometry, Biomedical Engineering, Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China; 2Department of Glaucoma, National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China; 3National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China*These authors contributed equally to this workCorrespondence: Wenzhe Zhou; Yanyan Chen, Email [email protected]; [email protected]: Patient decision aid (PDA) can help inform appropriate selection of laser peripheral iridotomy for primary angle closure suspect (PACS) or primary angle closure (PAC). This study assesses the impact of a PDA on the decision-making process of patients diagnosed with PACS or PAC when evaluating LPI treatment options.Patients and Methods: All participants were randomly assigned 1:1 to either the control group (n = 53), with an informed consent form, or to the intervention group with a PDA (n = 54). The primary outcome investigated was decisional conflict, which was assessed at baseline and again immediately following the intervention. The secondary outcomes included knowledge scores, patient satisfaction with their participation in the decision making, and decision regret.Results: A total of 107 participants with PACS or PAC were involved in this study. The post-intervention decisional conflict score of the intervention group was lower than that of the control group, and the difference in their scores was statistically significant (P < 0.001). Patients in the intervention group scored higher on the knowledge questionnaire than those in the control group after the intervention, showing a statistically significant difference (P < 0.001). Furthermore, no statistically significant differences were identified in the scores between the groups for patient satisfaction with participation in medical decision making (P = 0.721) or in decision regret (P = 0.104).Conclusion: In comparison to the control group, the application of the PDA enabled patients with PACS or PAC to be more informed, to experience reduced decisional conflict.Keywords: patient decision aid, primary angle closure suspect, primary angle closure, laser peripheral iridotomy, decisional conflict