Decisional Control Preferences in Managing Intraductal Papillary Mucinous Neoplasms of the Pancreas.

Objectives: To evaluate patient preferences for decision-making role in the management of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas and to identify characteristics associated with those preferences.

Background: Management of IPMNs is rooted in uncertainty with guidelines failing to incorporate patients' preferences.

Materials And Methods: A representative sample of participants evaluated a clinical vignette with the option to undergo surgery or surveillance for their IPMN. Their preferred role in decision-making was evaluated using the Control Preference Scale. The relationship between control preference and demographic/psychosocial variables was analyzed.

Results: Of the 520 participants in the study, most preferred an active role (65%), followed by shared (29%), and passive roles (6%) in the decision-making process. Lower health literacy was significantly associated with more passive control preference ( P  = 0.003). Non-active preference was significantly associated with Latino race compared to White race (odds ratio = 0.52, P  = 0.009). We found no significant association between control preference and education level or cancer anxiety.

Conclusions: Most patients prefer an active role in IPMN treatment decisions. Lower health literacy and Latino race were associated with a preference for non-active decision roles. Clinicians should strive to align patient involvement in IPMN treatment decisions with their patient's preferred role.