Patient Perspectives on Evolving Diverticulitis Treatment: An Assessment of Patient Willingness to Enroll in a Randomized Controlled Trial
Objective:. The objective of the study was to assess patients’ attitudes regarding participation in a randomized trial of antibiotics versus placebo for acute diverticulitis. Background:. Despite evidence that antibiotics may not be necessary to treat acute uncomplicated diverticulitis, they remain...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Health
2024-09-01
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| Series: | Annals of Surgery Open |
| Online Access: | http://journals.lww.com/10.1097/AS9.0000000000000476 |
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| author | Annie Altman-Merino, MD Kemberlee Bonnet, MA David Schlundt, PhD Jesse Wrenn, MD, PhD Wesley H. Self, MD, MPH Elisa J. Gordon, PhD, MPH Alexander T. Hawkins, MD, MPH |
| author_facet | Annie Altman-Merino, MD Kemberlee Bonnet, MA David Schlundt, PhD Jesse Wrenn, MD, PhD Wesley H. Self, MD, MPH Elisa J. Gordon, PhD, MPH Alexander T. Hawkins, MD, MPH |
| author_sort | Annie Altman-Merino, MD |
| collection | DOAJ |
| description | Objective:. The objective of the study was to assess patients’ attitudes regarding participation in a randomized trial of antibiotics versus placebo for acute diverticulitis.
Background:. Despite evidence that antibiotics may not be necessary to treat acute uncomplicated diverticulitis, they remain the mainstay of treatment in the United States. A randomized trial in the United States evaluating antibiotic effectiveness could accelerate the implementation of antibiotic-free treatment, but providers maintain concerns that patients may be unwilling to participate.
Methods:. This mixed-methods study conducted semi-structured interviews of patients presenting to a quaternary care emergency department with acute diverticulitis and a web-based survey of a larger cohort. The interviews assessed patients’ experiences with diverticulitis and perceptions of participation in a trial comparing antibiotics versus placebo. The survey quantified patients’ willingness to participate in such a study and the relative importance of factors influencing the process.
Results:. Thirteen patients completed an interview. Reasons to participate included a desire to help others or contribute to scientific knowledge. Doubts about the efficacy of observation as a treatment method were the main barrier to participation. In a survey of 218 subjects, 62% of respondents reported willingness to participate in a randomized clinical trial. “What my doctor thinks,” followed by “What I have experienced in the past” were the most important decision-making factors.
Conclusion:. Patients with acute uncomplicated diverticulitis maintain complex and varying perceptions of antibiotic use. Most surveyed patients would be willing to participate in a trial of antibiotics versus placebo. Our findings support the trial’s feasibility and may facilitate an informed approach to recruitment and consent. |
| format | Article |
| id | doaj-art-f0442926de854565ae139abd9638a85d |
| institution | Kabale University |
| issn | 2691-3593 |
| language | English |
| publishDate | 2024-09-01 |
| publisher | Wolters Kluwer Health |
| record_format | Article |
| series | Annals of Surgery Open |
| spelling | doaj-art-f0442926de854565ae139abd9638a85d2025-01-24T09:18:49ZengWolters Kluwer HealthAnnals of Surgery Open2691-35932024-09-0153e47610.1097/AS9.0000000000000476202409000-00038Patient Perspectives on Evolving Diverticulitis Treatment: An Assessment of Patient Willingness to Enroll in a Randomized Controlled TrialAnnie Altman-Merino, MD0Kemberlee Bonnet, MA1David Schlundt, PhD2Jesse Wrenn, MD, PhD3Wesley H. Self, MD, MPH4Elisa J. Gordon, PhD, MPH5Alexander T. Hawkins, MD, MPH6From the * Department of School of Medicine, Vanderbilt University, Nashville, TN† Department of Psychology, Vanderbilt University, Nashville, TN† Department of Psychology, Vanderbilt University, Nashville, TN‡ Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN§ Department of Emergency Medicine, Vanderbilt University Medical Center, Vanderbilt Institute for Clinical and Translational Research, Nashville, TN‖ Department of Surgery, and Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, Nashville, TN¶ Department of Surgery, Section of Colon & Rectal Surgery, Vanderbilt University Medical Center, Nashville, TN.Objective:. The objective of the study was to assess patients’ attitudes regarding participation in a randomized trial of antibiotics versus placebo for acute diverticulitis. Background:. Despite evidence that antibiotics may not be necessary to treat acute uncomplicated diverticulitis, they remain the mainstay of treatment in the United States. A randomized trial in the United States evaluating antibiotic effectiveness could accelerate the implementation of antibiotic-free treatment, but providers maintain concerns that patients may be unwilling to participate. Methods:. This mixed-methods study conducted semi-structured interviews of patients presenting to a quaternary care emergency department with acute diverticulitis and a web-based survey of a larger cohort. The interviews assessed patients’ experiences with diverticulitis and perceptions of participation in a trial comparing antibiotics versus placebo. The survey quantified patients’ willingness to participate in such a study and the relative importance of factors influencing the process. Results:. Thirteen patients completed an interview. Reasons to participate included a desire to help others or contribute to scientific knowledge. Doubts about the efficacy of observation as a treatment method were the main barrier to participation. In a survey of 218 subjects, 62% of respondents reported willingness to participate in a randomized clinical trial. “What my doctor thinks,” followed by “What I have experienced in the past” were the most important decision-making factors. Conclusion:. Patients with acute uncomplicated diverticulitis maintain complex and varying perceptions of antibiotic use. Most surveyed patients would be willing to participate in a trial of antibiotics versus placebo. Our findings support the trial’s feasibility and may facilitate an informed approach to recruitment and consent.http://journals.lww.com/10.1097/AS9.0000000000000476 |
| spellingShingle | Annie Altman-Merino, MD Kemberlee Bonnet, MA David Schlundt, PhD Jesse Wrenn, MD, PhD Wesley H. Self, MD, MPH Elisa J. Gordon, PhD, MPH Alexander T. Hawkins, MD, MPH Patient Perspectives on Evolving Diverticulitis Treatment: An Assessment of Patient Willingness to Enroll in a Randomized Controlled Trial Annals of Surgery Open |
| title | Patient Perspectives on Evolving Diverticulitis Treatment: An Assessment of Patient Willingness to Enroll in a Randomized Controlled Trial |
| title_full | Patient Perspectives on Evolving Diverticulitis Treatment: An Assessment of Patient Willingness to Enroll in a Randomized Controlled Trial |
| title_fullStr | Patient Perspectives on Evolving Diverticulitis Treatment: An Assessment of Patient Willingness to Enroll in a Randomized Controlled Trial |
| title_full_unstemmed | Patient Perspectives on Evolving Diverticulitis Treatment: An Assessment of Patient Willingness to Enroll in a Randomized Controlled Trial |
| title_short | Patient Perspectives on Evolving Diverticulitis Treatment: An Assessment of Patient Willingness to Enroll in a Randomized Controlled Trial |
| title_sort | patient perspectives on evolving diverticulitis treatment an assessment of patient willingness to enroll in a randomized controlled trial |
| url | http://journals.lww.com/10.1097/AS9.0000000000000476 |
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