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DOI: 10.1101/2023.06.26.23291565
¤ OpenAccess: Green
This work has “Green” OA status. This means it may cost money to access on the publisher landing page, but there is a free copy in an OA repository.

Complex Patient Perspectives on Evolving Diverticulitis Treatment

Annie E Altman-Merino,Kemberlee Bonnet,David G. Schlundt,Jessie Wrenn,Wesley H. Self,Elisa J. Gordon,Alexander T. Hawkins

Medicine
Randomized controlled trial
Diverticulitis
2023
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 controlled trial evaluating antibiotic effectiveness could accelerate implementation of an antibiotic-free treatment strategy, but patients may be unwilling to participate.This study aims to assess patients' attitudes regarding participation in a randomized trial of antibiotics versus placebo for acute diverticulitis, including willingness to participate.This is a mixed-methods study with qualitative and descriptive methods.Interviews were conducted in a quaternary care emergency department and surveys were administered virtually through a web-based portal.Patients with either current or previous acute uncomplicated diverticulitis participated.Patients underwent semi-structured interviews or completed a web-based survey. Main Outcome measures: Rates of willingness to participate in a randomized controlled trial was measured. Salient factors related to healthcare decision-making were also identified and analyzed.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've experienced in the past" were the most important decision-making factors.There is possible selection bias inherent to using a study to evaluate willingness to participate in a study. Also, the population sampled was disproportionately White compared to the population affected by diverticulitis.Patients with acute uncomplicated diverticulitis maintain complex and varying perceptions of the use of antibiotics. Most surveyed patients would be willing to participate in a trial of antibiotics versus placebo. Our findings support a trial's feasibility and facilitate an informed approach to recruitment and consent.
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    Complex Patient Perspectives on Evolving Diverticulitis Treatment” is a paper by Annie E Altman-Merino Kemberlee Bonnet David G. Schlundt Jessie Wrenn Wesley H. Self Elisa J. Gordon Alexander T. Hawkins published in 2023. It has an Open Access status of “green”. You can read and download a PDF Full Text of this paper here.