The development of a decision aid to support treatment choice in pelvic organ prolapse: a Delphi study

Background: Pelvic organ prolapse is a lifelong condition which affects the quality of life. It can be treated in different ways, but there is no evidence-based optimal treatment. Treatment options are pelvic floor muscle training, a pessary or surgery and treatment choice should depend on patient preference. The aim of this study is to develop a web-based decision aid to support treatment choice in patients with symptomatic pelvic organ prolapse. Methods: For the development of this decision aid an online Delphi consensus procedure was performed. Patients and gynaecologists rated their (dis)agreement concerning a list of statements using 5-point-likert scales. Value clarification exercises were included in the decision aid to help patients become more aware of their values. After the development of the decision aid using the results of the Delphi consensus procedure, a usability test for both patients and clinicians was performed. Results: Patients reached consensus in 11 out of 13 statements (85%). Clinicians reached consensus in 38 out of 44 statements (86%). The usability test yielded positive feedback regarding the comprehensibility, usability, images, the amount of information provided and the developed value clarification exercises. Both patients and clinicians showed strong preference for the use of a decision aid in the decision-making process. Conclusions: This decision aid was developed to support patients with symptomatic pelvic organ prolapse in the process of decision-making. A usability test with both patients and gynaecologist yielded positive feedback. The development of this online decision aid is a first step to improving the care for women with symptomatic pelvic organ prolapse. Trial registration: NL 55737.028.15, 30/10/16.