JMIR Publications

ABSTRACT

Background:

Diverticular disease is a common gastrointestinal diagnosis with >2.7 million clinic visits yearly. National guidelines from the American Society of Colon and Rectal Surgeons state that “the decision to recommend elective sigmoid colectomy after recovery from uncomplicated acute diverticulitis should be individualized.” However, tools to individualize this decision are lacking.

Objective:

Our aim was to develop an interactive educational decision aid to facilitate effective surgeon and patient communication about treatment options for recurrent left-sided diverticulitis.

Methods:

We used a modified design sprint methodology to create a prototype decision aid. We engaged a multidisciplinary team and adapted elements from the Ottawa Personal Decision Guide. We then iteratively refined the prototype by conducting a mixed-methods assessment of content and usability testing involving cognitive interviews with patients and surgeons. Findings informed the refinement of the decision aid. Further testing included in-clinic feasibility review.

Results:

Over a four-day in person rapid design sprint including patients, surgeons, and health communication experts, we developed a prototype of a diverticulitis decision aid comprised of an interactive website and handout with three discrete sections. The first section contains education about diverticulitis and treatment options. The second section clarifies the potential risks and benefits of both clinical treatment options (medical management vs colectomy). The third section invites patients to participate in a values clarification exercise. After navigating the decision aid, the patient prints a synopsis that they bring to their clinic appointment where it serves as a guide for shared decision-making.

Conclusions:

Design sprint methodology emphasizing stakeholder co-design and complemented by extensive user testing is an effective and efficient strategy to create a decision aid for patients living with recurrent diverticulitis facing critical treatment decisions.