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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

Harcourt, Diana; Paraskeva, Nicole; White, Paul; Powell, Jane; Clarke, Alex

Authors

Paul White Paul.White@uwe.ac.uk
Associate Professor in Applied Statistics

Jane Powell Jane.Powell@uwe.ac.uk
Professor in Public Health Economics

Alex Clarke



Abstract

© 2017 The Author(s). Background: Increasingly, 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. Methods: A 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). Discussion: PEGASUS 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 registration: ISRCTN 18000391 (DOI 10.1186/ISRCTN18000391) 27/01/2016.

Journal Article Type Article
Publication Date Oct 2, 2017
Journal BMC Medical Informatics and Decision Making
Electronic ISSN 1472-6947
Publisher BMC
Peer Reviewed Not Peer Reviewed
Volume 17
Issue 1
Pages 143
APA6 Citation Harcourt, D., Paraskeva, N., White, P., Powell, J., & Clarke, A. (2017). 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, 17(1), 143. https://doi.org/10.1186/s12911-017-0543-0
DOI https://doi.org/10.1186/s12911-017-0543-0
Keywords breast cancer, breast reconstruction, Ductal Carcinoma In Situ (DCIS), mastectomy, Pegasus, risk reducing mastectomy, shared decision making, visible difference, body image
Publisher URL http://dx.doi.org/10.1186/s12911-017-0543-0

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