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Patient Satisfaction and Attainment of Patient-specific Goals after Endobronchial Valve Treatment.

RATIONALE
Bronchoscopic lung volume reduction with endobronchial valves (EBV) significantly improves clinical outcomes in patients with severe emphysema. However, patient-reported outcomes like patient satisfaction and patient specific treatment goals were never investigated.


OBJECTIVE
Therefore, our aim was to investigate patient satisfaction level 1 year after treatment and patient-specific goals before and 1 year after EBV treatment. Furthermore, to investigate whether the level of patient satisfaction or change in goals was associated with change in clinical outcome.


METHODS
We prospectively included patients who underwent EBV treatment as part of regular care in our hospital and asked patients to report and score their personal treatment goals on the patient-specific complaint questionnaire (PSC) at baseline and after 1 year follow up and to complete a patient-satisfaction questionnaire at 1 year follow up.


RESULTS
Of the 134 patients who were treated with EBV, 109 filled out the patient-satisfaction questionnaire and 88 the PSC at baseline and 1 year after treatment. When adjusting for the patients who were lost-to follow up, in total 91% of the patients would recommend the EBV treatment to other patients. Seventy-five percent of the patients was (very) satisfied with the treatment and 11% was (very) unsatisfied. The 3 most frequently reported patient specific goals to improve were walking (reported by 77% of the patients), taking a shower/washing/getting dressed (35%) and household chores (32%). Both the total PSC questionnaire sum score (mean change -6.01 ± 6.0) and all individual reported goals significantly improved 1 year after treatment (p<0.001). Furthermore, a higher patient satisfaction level and larger improvement in goals was significantly associated with an improvement in FEV1, residual volume, dyspnea severity and quality of life.


CONCLUSIONS
We found that the patient satisfaction level is high and patient-specific goals significantly improve, 1 year after EBV treatment. We believe that individual patient's goals are important in the process of shared decision making before treatment as it can identify unrealistic expectations beforehand and prevent disappointment afterwards. Clinical trial registered at ClinicalTrials.gov (NCT02815683).