Effect of patient decision aids on choice between sugammadex and neostigmine in surgeries under general anesthesia: a multicenter randomized controlled trial

doi:10.4097/kja.22624

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Title:	Effect of patient decision aids on choice between sugammadex and neostigmine in surgeries under general anesthesia: a multicenter randomized controlled trial
Authors:	Wang, Li-Kai Lin, Yao-Tsung Chen, Jui-Tai Lan, Winnie Hung, Kuo-Chuan Chen, Jen-Yin Liu, Kuei-Jung Yen, Yu-Chun Chou, Yun-Yun Cherng, Yih-Giun Tam, Ka-Wai
Contributors:	Chi Mei Med Ctr, Dept Anesthesiol Chia Nan Univ Pharm & Sci, Dept Hosp & Hlth Care Adm, Coll Recreat & Hlth Management Taipei Med Univ, Shuang Ho Hosp, Dept Anesthesiol Taipei Med Univ, Coll Med, Sch Med, Dept Anesthesiol Taipei Med Univ, Shuang Ho Hosp, Dept Gen Med Taipei Med Univ, Biostat Ctr, Off Data Sci Shared Decis Making Resource Ctr Taipei Med Univ, Shuang Ho Hosp, Dept Surg, Div Gen Surg Cochrane Taiwan Taipei Med Univ, Coll Med, Sch Med, Dept Surg,Div Gen Surg Taipei Med Univ, Shuang Ho Hosp, Dept Anesthesiol Taipei Med Univ, Shuang Ho Hosp, Shared Decis Making Resource Ctr
Keywords:	Anesthesia Decision making Decision support techniques Neostigmine Psy-chological conflict Sugammadex
Date:	2023
Issue Date:	2024-12-25 11:05:13 (UTC+8)
Publisher:	KOREAN SOC ANESTHESIOLOGISTS
Abstract:	Background: Shared decision making using patient decision aids (PtDAs) was established over a decade ago, but few studies have evaluated its efficacy in Asian countries. We there-fore evaluated the application of PtDAs in a decision conflict between two muscle relaxant reversal agents, neostigmine and sugammadex, and sequentially analyzed the regional dif-ferences and operating room turnover rates. Methods: This multicenter, outcome-assessor-blind, randomized controlled trial included 3,132 surgical patients from two medical centers admitted between March 2020 and Au-gust 2020. The patients were randomly divided into the classical and PtDA groups for pre-anesthesia consultations. Their clinicodemographic characteristics were analyzed to identify variables influencing the choice of reversal agent. On the day of the pre-anesthesia consultation, the patients completed the four SURE scale (sure of myself, understand in-formation, risk-benefit ratio, encouragement) screening items. The operating turnover rates were also evaluated using anesthesia records. Results: Compared with the classical group, the PtDA group felt more confident about re-ceiving sufficient medical information (P < 0.001), felt better informed about the advan-tages and disadvantages of the medications (P < 0.001), exhibited a superior understand-ing of the benefits and risks of their options (P < 0.001), and felt surer about their choice (P < 0.001). Moreover, the PtDA group had a significantly greater tendency to choose sugam-madex over neostigmine (P < 0.001). Conclusions: PtDA interventions in pre-anesthesia consultations provided surgical pa-tients with clear knowledge and better support. PtDAs should be made available in other medical fields to enhance shared clinical decision-making.
Relation:	Korean Journal of Anesthesiology, v.76, n.4, pp.280-289
Appears in Collections:	[Offices] 456

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