Decision Regret In Breast Reconstruction Patients Following Preconsultation Education Group Intervention: A Randomized Controlled Trial
Feras Shamoun, BSc, Benita Hosseini, PhD, Toni Zhong, MD, MHS.
University Health Network, Toronto, ON, Canada.
Purpose: Decision regret is an important long-term outcome in evaluating decision-making following surgery. The decision to undergo postmastectomy breast reconstruction (PMBR) is complex. We developed the Preconsultation Education Group Intervention (PEGI) as a decision support tool to educate patients about PMBR. PEGI was previously shown to significantly increase patient knowledge of PMBR. In this study, we investigate the effect of PEGI on decision regret at 6 months postconsultation.
Methods: PMBR patients were randomized to PEGI or routine education (control) groups preconsultation. Patients filled questionnaires at baseline (T0), one week postconsultation (T1) and 6 months postconsultation (T2). Outcome measures were assessed using the BREAST-Q Satisfaction with Information at T1, Decision Regret Scale at T2, and State-Trait Anxiety Inventory (STAI) at T2.
Results: Of the 156 patients randomized, 137 patients completed T1 assessments. Satisfaction with Information was significantly higher at T1 in PEGI with a median (IQR) of 75 (60, 85) compared to controls with 64 (51, 74) (p=0.02), At T2, 97 patients completed their outcome measures. Decision regret was low overall, with 19.6%, 40.2%, 40.2% expressing none, mild, or moderate regret, respectively, with no difference between groups. Furthermore, we found that undergoing PMBR was associated with lower decision regret (r= -0.344, p=0.001). Lower decision regret was also associated with lower anxiety levels at T2 (rs= 0.374, p<0.001).
Conclusion: Participating in PEGI increased patient reported satisfaction with information but had no effect on long-term decision regret. Irrespective of preconsultation education, lower long-term decision regret was associated with undergoing PMBR and reduced anxiety.
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