Patient Perspectives on Evolving Diverticulitis Treatment: An Assessment of Patient Willingness to Enroll in a Randomized Controlled Trial

Autor: Annie Altman-Merino, MD, Kemberlee Bonnet, MA, David Schlundt, PhD, Jesse Wrenn, MD, PhD, Wesley H. Self, MD, MPH, Elisa J. Gordon, PhD, MPH, Alexander T. Hawkins, MD, MPH
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Annals of Surgery Open, Vol 5, Iss 3, p e476 (2024)
Druh dokumentu: article
ISSN: 2691-3593
00000000
DOI: 10.1097/AS9.0000000000000476
Popis: Objective:. The objective of the study was to assess patients’ attitudes regarding participation in a randomized trial of antibiotics versus placebo for acute diverticulitis. Background:. Despite evidence that antibiotics may not be necessary to treat acute uncomplicated diverticulitis, they remain the mainstay of treatment in the United States. A randomized trial in the United States evaluating antibiotic effectiveness could accelerate the implementation of antibiotic-free treatment, but providers maintain concerns that patients may be unwilling to participate. Methods:. This mixed-methods study conducted semi-structured interviews of patients presenting to a quaternary care emergency department with acute diverticulitis and a web-based survey of a larger cohort. The interviews assessed patients’ experiences with diverticulitis and perceptions of participation in a trial comparing antibiotics versus placebo. The survey quantified patients’ willingness to participate in such a study and the relative importance of factors influencing the process. Results:. Thirteen patients completed an interview. Reasons to participate included a desire to help others or contribute to scientific knowledge. Doubts about the efficacy of observation as a treatment method were the main barrier to participation. In a survey of 218 subjects, 62% of respondents reported willingness to participate in a randomized clinical trial. “What my doctor thinks,” followed by “What I have experienced in the past” were the most important decision-making factors. Conclusion:. Patients with acute uncomplicated diverticulitis maintain complex and varying perceptions of antibiotic use. Most surveyed patients would be willing to participate in a trial of antibiotics versus placebo. Our findings support the trial’s feasibility and may facilitate an informed approach to recruitment and consent.
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