Optimising intervals for abdominal aortic aneurysm surveillance: A pilot study analysing patient opinion

Abstract

Introduction

Optimising abdominal aortic aneurysm surveillance intervals will improve current surveillance programmes. To the author’s knowledge, no known study has exclusively asked patient opinion with regards to their surveillance interval. The aim of this study was to therefore determine a patient’s perspective of their optimal intervals, encouraging shared decision-making and creating a patient-focused service.

Methods

Fifty patients, currently under abdominal aortic aneurysm surveillance, were interviewed. Patients were asked their opinions before and after seeing a patient decision aid. A patient decision aid presents information of risk in an easy-to-understand format. This specific patient decision aid, designed and created for this study, informed patients of the ‘risk of exceeding the 5.5 cm surgical threshold’ with regards to various surveillance intervals. The chosen optimal surveillance interval was recorded for each patient, and a median interval was calculated for each abdominal aortic aneurysm group. Groups were categorised based upon maximum aortic diameter (3.0–3.4 cm, 3.5–3.9 cm, 4.0–4.4 cm and 4.5–4.9 cm).

Results

After assessing the patient decision aid, the median surveillance interval calculated for each abdominal aortic aneurysm group was 24 months (3.0–3.4 cm), 12 months (3.5–3.9 cm), 12 months (4.0–4.4 cm) and 6 months (4.5–4.9 cm), respectively. The majority of patients (78%, n = 39) agreed that the patient decision aid was a useful tool to help make an informed choice.

Conclusion

Overall, patients in abdominal aortic aneurysm groups 3.0–3.4 cm and 4.5–4.9 cm would choose to lengthen abdominal aortic aneurysm surveillance intervals. Lengthening the current surveillance intervals to 24 months (currently 12 months) for abdominal aortic aneurysm group 3.0–3.4 cm and to 6 months (currently 3 months) for abdominal aortic aneurysm group 4.5–4.9 cm would not only increase capacity but also reflect the needs and wishes of those using the National Health Service. The use of a patient decision aid is an effective way of communicating, to the patient, the risk of the proposed changes and thus alleviating potential anxiety.