Enhancing Patient-Centric Care in Before OAB Procedures


Panelists discuss the importance of patient-centric approaches in the procedural treatment of overactive bladder (OAB). They share their practices in preparing patients for procedures, including patient education, shared decision-making, and tailoring pre-procedure instructions, with a focus on managing patient expectations and addressing fears. The episode emphasizes the role of the clinical team in ensuring patient comfort, highlighting practical considerations, real-world experiences, and best practices for optimizing patient-centered care in OAB management.


Dr. Kennelly: So let's talk a little bit about in-office therapies that we do. Currently, most people have had experience in either PT &S therapy in office or a botulin toxin in office, possibly P &Es in the office, the actual implants happen in the operating room. But really, office practice is what I want to kind of focus on during this kind of area and more procedural basis. And just for probably clarity, so everyone knows where it is, that why don't we just talk at this point just about botulin toxin injection in the office just to make it, you know, straightforward. So I'm interested in hearing are there things that you both do sort of before the procedure to kind of put yourself in the walk in the patient shoes? What are the patients going through and how do you prepare a patient for let's say a botulinum toxin procedure? Dr. Eilber, do you have specific things that you do ahead of time?

Dr Eilber: Yes, I think from the get go, like Dr. Benson was saying, whether I know the patient will ever have Botox or not, I think that when you're seeing an OAB patient for the first time, you do have to at least at a high level present all the different therapies. Because I think we make the mistake of only going over behavioral modification, maybe briefly mentioning medication, and then if the patient has respond to either one of those, if they don't know there's something else available, they kind of give up.But it also just plants the seed because I think for the first time for many people, they're hearing what Botox and implant for my overactive bladder. So that way at least, it's some of them to think about, if there are patient brochures around, I will oftentimes send them home with the patients, with the disclaimer of, if you read this in all detail, please don't be horrified of side effects. Reminding them that when we see these erectile dysfunction meds on TV, they mention you could drop dead. People still take those. And when I see them or have the telehealth and they have maybe failed their medication, then I really start talking about it and walk him through. So if we do the Botox, what'll happen? There's no special preparation. You can eat. you don't have to have anybody drive you. We just use local anesthesia, will numb your bladder and just really walk them through everything. And even when they arrive, we're still walking them through the same thing. I think people just get really anxious when you just start doing things in silence, even if you mentioned it before. And verbal anesthesia, I don't think you can underestimate that at all. I think the more you talk, the better people do.

Dr Kennelly: Right, it seems like what you're saying is really focusing on even before the therapy or the procedure that's being done, you really have to prepare for that. Proper prior planning will help. And so just handing them brochures may not be enough. You kind of have to navigate and walk them through. Do you have your staff well informed on this area? So let's say a patient before the procedure, Dr. Benson, do you have your staff? contacting them? Do you have virtual visits? Like, is there a check -in before like the day of the procedure? -

Dr. Benson: So kind of the analogy I use, Dr. Kennelly, is I always say, if you went for an oil change at Toyota, you would expect everybody at the dealership to know what kind of cars you take care of, how you change oil, you'd expect that experience to be consistent and be favorable. And so we have everybody at the dealership that touches this patient's experience to be aware. We have all of our staff members come in and see the procedure, so they can actually say they've seen it. We've had a few of our staff members that receive it, so they are really good advocates. But it's consistency and it's that messaging that Dr.Eilber mentioned from day one that they're already somewhat familiar to it. And I think you can't overestimate how little touches make a difference in a whole that is that when a patient comes in, most of them should already really understand how it's gonna proceed.

So we've written a little lay person's description of the procedure of what you do before, of what you can expect afterward. And we actually send home a packet for patients who are anticipating may go on to a call. additional cares. They receive a handwritten packet from us in lay person's terms about each of these technologies. So again, you're not having an entire discussion with every aspect of a procedure at one time. And I think that so many patients ask the people around you more about the procedure than they do you, right? So you come in as the provider, but they've already had three conversations before you've ever gotten there. there, right? So if they've gotten that reassurance, if they've had that kind of hand -holding that's helps and the verbal anesthesia component for sure, that's top of the list, right? But not only just me, it's my staff having that with them, right? So, you know, while I might be the technician doing it, it's like good magic, it's the art of distraction, right? So it's the other people in the room, it's the sounds in the room, it's, you know, whatever you want. you might do to pull them away from where they're at. And then being a good technician, right? Being able to get it in, do it efficiently, not be floundering with things, have everything prepared in the room so it's ready to go. And I think that's critical.

Dr Kennelly: Yeah, I think you bring up some great points and, you know, the sort of reiterating, it's really making sure everyone on board knows their role, knows their job. I like the fact that you've had people watch the procedure all the people that are working within your staff so they're aware of it. I like the fact that you have standard pre procedure forms and even post procedure forms that kind of walk people that they can refer back to kind of afterwards so you're really setting goals set in expectation, which is great to do.

*Video transcript is AI-generated and reviewed by Urology Times® editorial staff.

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