My Anesthesia Choice-HF: Development and Preliminary Testing of a Tool to Facilitate Conversations About Anesthesia for Hip Fracture Surgery

11 Pages Posted: 3 May 2023

See all articles by Mark D. Neuman

Mark D. Neuman

University of Pennsylvania - Department of Anesthesiology and Critical Care Medicine

Glyn Elwyn

Dartmouth College

Veena Graff

University of Pennsylvania - Department of Anesthesiology and Critical Care Medicine

Viktoria Schmitz

Washington University in St. Louis - Division of Public Health Sciences

Mary C. Politi

Washington University in St. Louis - Division of Public Health Sciences

Abstract

Objective: Patients often desire involvement in anesthesia decisions, yet clinicians rarely explain anesthesia options or elicit preferences. We developed My Anesthesia Choice-HF, a conversation aid about anesthesia options for hip fracture surgery, and tested its preliminary efficacy and acceptability.

Methods: We refined the aid with feedback from anesthesiologists, decision scientists, and community advisors. We conducted an online survey of English-speaking adults aged 50 and older. Participants imagined choosing between spinal and general anesthesia for hip fracture surgery, and completed decisional conflict and knowledge measures, before and after viewing the aid and rated the aid’s acceptability.

Results: Of 364/409 valid respondents, mean age was 64 (SD 8.9) and 59% were female. The proportion indicating decisional conflict decreased after reviewing the aid (63% to 34%, P<0.001). Median knowledge scores increased (50% to 67% correct; P<0.001). 83% agreed that the aid would help them discuss options and preferences. 76.4% would approve of doctors using it.

Conclusion.: My Anesthesia Choice-HF decreased decisional conflict and increased knowledge about anesthesia choices for hip fracture surgery. It was highly acceptable.Innovation. My Anesthesia Choice-HF represents a novel strategy to support shared decision-making in anesthesia care. Future work should focus on validating these findings in a clinical setting.

Note:
Funding Declaration: The study was supported by internal funds from the Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia and the Department of Surgery, Washington University in St. Louis.

Conflicts of Interest: MCP was a consultant for UCB Biopharma in 2022 on a topic unrelated to this manuscript. GE is the Founder and Director of Sharpnet Work, LLC, a provider of training for shared decision making. He provides advice in the domain of shared decision making and patient decision aids to (1) Access Community Health Network, Chicago (Adviser to Federally Qualified Medical Centers), (2) EBSCO Health for Option GridsTM patient decision aids, (3) Bind On Demand Health Insurance, (4) PatientWisdom Inc, and (5) Abridge AI Inc. No other authors declare competing interests.

Ethical Approval: The study was deemed exempt from institutional review board (IRB) review by the Washington University in St. Louis IRB.

Keywords: Anesthesia, Decision aids, Orthopedic Surgery, hip fractures

Suggested Citation

Neuman, Mark D. and Elwyn, Glyn and Graff, Veena and Schmitz, Viktoria and Politi, Mary C., My Anesthesia Choice-HF: Development and Preliminary Testing of a Tool to Facilitate Conversations About Anesthesia for Hip Fracture Surgery. Available at SSRN: https://ssrn.com/abstract=4428609 or http://dx.doi.org/10.2139/ssrn.4428609

Mark D. Neuman (Contact Author)

University of Pennsylvania - Department of Anesthesiology and Critical Care Medicine ( email )

Glyn Elwyn

Dartmouth College ( email )

Department of Sociology
Hanover, NH 03755
United States

Veena Graff

University of Pennsylvania - Department of Anesthesiology and Critical Care Medicine ( email )

Viktoria Schmitz

Washington University in St. Louis - Division of Public Health Sciences ( email )

Mary C. Politi

Washington University in St. Louis - Division of Public Health Sciences ( email )

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