Objective: To evaluate the impact of a deep brain stimulation (DBS) decision aid for DBS for patients with Parkinson’s disease (PD).

Background: The decision to undergo DBS surgery for PD is complex and often associated with uncertainty. Decision support tools may improve decisional outcomes by facilitating shared decision making.

Method: We conducted a pre–post pilot study among PD patients beginning the evaluation process for DBS. Participants in each phase completed questionnaires at the start and end of the evaluation process. In the usual care phase, participants received standard care consisting of discussions with the DBS team. In the decision aid phase, participants additionally received a paper decision aid after completing baseline questionnaires. Primary outcomes were decisional conflict and decision satisfaction. Decision readiness and expectations for DBS were also assessed. Participants in the decision aid group completed an acceptability questionnaire. Changes in decisional conflict and differences in decision satisfaction were analyzed using Wilcoxon signed-rank tests.

Results: Thirty-two participants completed baseline questionnaires in the usual care group, of whom 17 completed post-evaluation questionnaires. In the decision aid group, 25 completed baseline and 14 completed post questionnaires. The most bothersome symptoms were tremor, followed by OFF time, and dyskinesia. Participants most commonly hoped for improved motor symptoms, reduced OFF time, improved daily function, and decreased medication use. Decisional conflict decreased from 35.7(18.5) to 18.9(16.1) in the usual care group (p=0.007) and from 34.8(15.9) to 21.5(13.9) in the decision aid group (p=0.02), with no significant difference between groups. Decision readiness increased in both groups (usual care: 3.4 to 4.4, p=0.02; decision aid: 3.6 to 4.1, p=0.01). A higher proportion of patients were satisfied with their decision in the decision aid group (71.4%) compared with usual care (58.8%), although this difference was not statistically significant. Among decision aid users, 93% reported the tool was helpful, 93% would recommend it to others, and 93% were satisfied with its quality.

Conclusion: Decisional conflict decreased during the DBS evaluation process in both groups. The decision aid was highly acceptable and may improve aspects of the decision-making experience, supporting further evaluation in larger studies.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/evaluating-a-decision-aid-for-deep-brain-stimulation-in-parkinsons-disease-results-of-a-pre-post-pilot-study/