Developing a patient decision aid for Femoroacetabular Impingement Syndrome: A mixed-methods study

Background Femoroacetabular Impingement Syndrome (FAIS) is a prominent source of non-arthritic hip pain and is highly prevalent in young active populations. Decisions to undergo surgery are significant in nature and require proper understanding of potential benefits and risks. Objective To develop and user-test a patient decision aid comparing non-surgical management and hip arthroscopy for FAIS with an additional military-related section. Design Mixed-methods. Method The initial draft of the decision aid was developed by a multidisciplinary steering group. An iterative process of semi-structured interviews, re-drafting and further interviews provided feedback on the decision aid. The interviews were analysed reflexively using thematic analysis for qualitative findings. Acceptability questionnaires were analysed using descriptive statistics for quantitative findings. Results We interviewed 27-participants; 13 clinicians (6 physiotherapists, 3 orthopaedic surgeons, 2 general practitioners, 1 sports medicine doctor, 1 anaesthesia pain physician) and 14 patients. Most participants rated the decision aid's acceptability as good-to-excellent. Participants agreed on most aspects of the decision aid including the introduction, treatment options, comparison of outcomes and questions to consider asking a health professional. Participants agreed on including more information on the treatment options and provide more long-term outcomes comparing the options. Our decision aid met all 6 of the International Patient Decision Aid Standards qualifying criteria. Conclusion Our decision aid was considered a useful tool that may help patients choose an appropriate treatment option for the management of FAIS. A clinical trial evaluating the impact of the decision aid on decision making for patients considering surgery for FAIS is needed.