Creation and Testing of an Education Decision Aid for Colectomy in Recurrent Diverticulitis

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PROJECT SUMMARY/ABSTRACT Diverticulosis of the sigmoid colon is a significant burden to the US health system. Complications lead to substantial morbidity and mortality. In 2004, diverticular disease was responsible for 313,000 hospitalizations, 1.9 million ambulatory care visits, and 3365 deaths in the United States. Indications for surgical management of chronic or recurrent diverticulitis are poorly defined. A number of studies have revealed that there is minimal mortality benefit to elective surgery for diverticular disease. Rather, the decision to pursue surgery is based on both risk of surgery and potential improvement in quality of life. Despite the need for effective communication about the risks and benefits of surgery, no shared decision-making tools exist to guide the surgeon and patient. This proposal describes a two-year proposal to address this important knowledge gap. The research specific aims are: 1) to develop an interactive decision aid to facilitate communication between patients and surgeons considering surgery for recurrent diverticulitis; 2) conduct a pilot randomized controlled trial comparing use of the decision aid with standard care. These objectives are in concert with the parent K23 application’s goal to evaluate both the decision to undergo surgery and the natural history of Patient Reported Outcomes for patients with recurrent diverticulitis. This application furthers the overall goal of the parent award by using data and analysis from both the mixed methods study and longitudinal assessment to better inform the decision-making process. The proposed educational intervention will be designed specifically to permit dissemination to a variety of care settings including those with vulnerable patient populations, such as those with low health literacy. Overall, this award will advance the P.I.’s experience in shared decision making and generate important data on crucial elements of shared decision making in patients with diverticular disease.