Dupuytren contracture: using qualitative data to inform a conceptual framework for shared decision-making

J Hand Surg Eur Vol. 2022 Nov 3;17531934221133992. doi: 10.1177/17531934221133992. Online ahead of print.

Abstract

Multiple treatment options are available to patients with Dupuytren contracture, making shared decision-making complex. Our rigorous qualitative analysis sought to understand patient perceptions of shared decision-making in Dupuytren contracture treatment and create a conceptual framework to optimize patient-physician communication. We interviewed 30 patients with Dupuytren contracture to learn about their experience with treatment selection. The following themes were integral to shared decision-making for Dupuytren contracture treatment: discussing disease progression and treatment initiation, presenting all available treatment options, assessing patients' pre-existing biases towards treatment, patient values and preferences for treatment trade-offs, treatment risks and benefits, physician recommendation and active patient participation. This model can optimize communication about treatment options and expectations for relevant outcomes including, recovery time, contracture recurrence, complications, and treatment-related expenses.Level of evidence: V.

Keywords: Dupuytren contraction; Shared decision-making; conceptual framework; patient-informed; qualitative.