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A National Survey of Patient Perceptions, Attributes, and Satisfaction Related to Dupuytren's Contracture (DC) Diagnosis and Treatment Options: Surgery, Collagenase Clostridium Histolyticum (CCH) Injection, and Needle Aponeurotomy
Philip E. Blazar, MD
1, Jason Nydick, DO
2, Nirav Gupta, DO
3, David Hurley, MD
4, Sherry Chen, MS
4; Mark Vitale, MD
5(1)Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA, (2)Florida Orthopaedic Institute, Tampa, FL, (3)Twin Palm Orthopedics, Ocala, FL, (4)Endo USA, Inc., Malvern, PA, (5)Yale New Haven Health Greenwich Hospital, Greenwich, CT
Introduction: Patient experiences with DC treatment remain underexplored. This study examined patient perceptions of DC and its treatments, including treatment-related attributes. Among those treated, satisfaction and treatment timing preferences were also described.
Materials & Methods: An online survey of a sample of US adults was conducted in March 2024. Respondents were eligible if diagnosed with DC by a healthcare provider or they self-reported DC, confirmed through screening questions or photos. Questions assessed DC screening/diagnosis, demographics, disease perceptions, treatment attributes, and satisfaction across the DC treatments (surgery, CCH injection, and needle aponeurotomy). Results were analyzed using descriptive statistics.
Results: Respondents (N=200) were 56% male, 74% White, and slightly skewed toward an older population (<45y, 28%; 45-65y, 30%; >65y, 42%), with 45% (n=90) undiagnosed/untreated, 27% (n=54) diagnosed/untreated, and 28% (n=56) diagnosed/treated. When comparing disease perceptions across the DC diagnosis/treatment experience, only 57% of diagnosed/treated and 28% of diagnosed/untreated patients associated "can reoccur/come back after treatment" with DC. Among diagnosed/treated respondents, 75% associated "is treatable" with DC vs 59% diagnosed/untreated and 43% undiagnosed. Among undiagnosed respondents, 23% believed DC "can go away on its own," vs 4% diagnosed/treated and 6% diagnosed/untreated. For all diagnosed patients, 5% of treated vs 26% of untreated patients believed "I should wait until it gets really bad to treat." Among patients who were familiar with each specific DC treatment, the top-endorsed attribute for each treatment was "I trust the doctor's abilities when they are administering the treatments" for surgery (65%), "is convenient" for CCH (75%), and "minimally invasive/non-surgical" for needle aponeurotomy (63%) (
Figure). Among treated respondents (n=56), treatment satisfaction was greatest for CCH (91%, n=20/22) over surgery (76%, n=25/33) and needle aponeurotomy (73%; n=19/26). Additionally, most respondents who underwent CCH treatment wished they had started the treatment sooner (73%, n=16/22), while nearly half expressed the same sentiment for needle aponeurotomy (46%, n=12/26) and hand surgery (45%, n=15/33).
Conclusions: These findings highlight a need for increased education about DC, as many undiagnosed patients remain unaware that it is a treatable condition. Most treated respondents reported wishing they had initiated treatment earlier, underscoring the importance of timely diagnosis and informed decision-making. Enhancing awareness and supporting patient-provider conversations may help improve recognition and management of DC.
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