Enhancing Patient Decision-Making in Breast Reconstruction: A Systematic Review of Decision Aid Efficacy

Abstract

Background: Patients often struggle to select a breast reconstruction option that aligns with their personal values. Decision aids have become popular tools to assist patients in navigating these choices. This systematic review assesses the effectiveness of available breast reconstruction decision aids. Methods: We conducted a comprehensive search across five databases from inception to December 2022, identifying studies related to the development, validation, or implementation of decision aids in breast reconstruction. Results: Out of 4621 reports, 24 studies met inclusion criteria, covering 14 unique decision aids. These included 13 randomized controlled trials, 9 qualitative studies, and 2 case series. Nine studies reported reduced decisional conflict and 2 studies showed decreased decisional regret. Additionally, 13 studies found improved satisfaction with the information provided, and all seven studies that measured knowledge retention showed improvements. However, none of the studies found a reduction in anxiety or depression following the use of decision aids. Conclusions: Decision aids are effective in reducing decisional conflict, enhancing patient satisfaction, and improving knowledge retention in breast reconstruction. Future research should focus on integrating these tools into clinical practice.