Development of a patient decision aid on subacromial decompression surgery and rotator cuff repair surgery: an international mixed-methods study

Review written by Dr Angela Cadogan info

Key Points

  1. Clear diagnostic criteria and multidisciplinary agreement on clinical pathways (non-surgical and surgical management) for specific conditions are required for the development of effective patient decision aids, to ensure that patients receive consistent messages regardless of their point of contact in the health system.
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BACKGROUND & OBJECTIVE

Subacromial pain is a clinical diagnosis that encompasses a range of pathologies including bursitis, tendinopathy (calcific and non-calcific) and rotator cuff tears. Subacromial decompression surgery and rotator cuff repair surgery (with or without decompression) is frequently performed for people with subacromial pain. However, recent evidence suggests that outcomes for pain and function are similar for both surgical and non-surgical treatments for atraumatic subacromial pain (1).

Compared with non-surgical treatment, surgery is associated with significantly higher cost, complications, and recovery times. Patient decision aids present unbiased information on the benefits and harms of different healthcare options, and such an aid may help people with subacromial pain make more informed treatment choices and reduce the use of unnecessary surgery.

Recent evidence suggests that outcomes for pain and function are similar for both surgical and non-surgical treatments for atraumatic subacromial pain.
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There was disagreement between health professionals on the explanation of causes of symptoms (pathoanatomic vs other factors).

METHODS

In this mixed-methods study, the authors convened a multidisciplinary steering group and drafted a decision aid for treatment options for subacromial pain, with guidance from the International Patient Decision Aids Standards (IPDAS), with the aim of evaluating useability and acceptability

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