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NCT Number: NCT07505238

Informing Patients About Their Surgery's Environmental Impact: an Effective Pathway to Sustainable Healthcare?

The healthcare sector contributes significantly to climate change. Reducing the number of patients receiving resource-intensive procedures such as surgery can lower carbon emissions, particularly when two treatments with comparable clinical outcomes are available. Nevertheless, the impact of incorporating environmental considerations into patients' decision-making processes remains underexplored. The investigators examine how including information about the environmental impact of treatment options in a gallstone decision aid affects patients' real-life choice between surgery and the more sustainable alternative of conservative treatment. Moreover, the investigators examine whether factors such as severity of symptoms moderate the relation between sustainability information and patients' treatment choice. An exploratory vignette study informed the hypotheses that will be tested among actual patients with gallstones making actual treatment decisions. The results of this ecologically valid study have implications for both clinical practice and healthcare policy by offering insight into the effectiveness of pathways to include patients in the transition towards sustainable healthcare.

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Key information

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

University of Amsterdam

Amsterdam, North Holland, Netherlands

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Patients who were referred to three participating hospitals located across the Netherlands
  • Patients who received PatientPlus' gallstone decision aid in preparation for their surgical consultation

Exclusion criteria

  • None

Treatment and study plan

Sustainability added to decision aid

Behavioral

The intervention decision aid includes a page with information about the environmental impact of surgical removal of the gallbladder, and a control condition, which includes no such information. Besides information about the environmental impact of gallbladder surgery, the intervention and control conditions will be identical. At the end of the decision aid patients will be debriefed in general phrasing (i.e., the aim of this study was to examine which factors affect treatment choice) to prevent influencing the actual decision. Approximately three months after patients received the decision aid, patients will receive an invitation via the PatientPlus portal to complete a survey in which the investigators inquire about their final treatment decision (first reminder after one week, second reminder after two weeks). At the end of this survey, patients will be debriefed about the aim of examining how information about the environmental impact of surgery affects treatment choice.

Primary outcomes

  1. Treatment preference (surgery or wait-and-see)

    Time frame: baseline, pre-intervention

    The primary outcome is treatment preference. Specifically, participants will indicate their treatment preference by selecting either the option 'Surgery' or 'Wait and see' (dichotomous variable)

Secondary outcomes

  1. Treatment certainty

    Time frame: baseline, pre-intervention

    Combination of treatment preference and certainty. Treatment certainty will be determined by answering the question 'How sure are you about what you want?' on a scale from 1 (Very uncertain) to 10 (Very certain). Treatment preference*certainty will be calculated after data collection by multiplying treatment preference (coded as 1 for surgery and -1 for wait and see thus no surgery) with treatment certainty, resulting in a scale from -10 (Very certain about choosing no surgery) to +10 (Very certain about choosing surgery). Adding this continuous measure allows for capturing more nuanced differences between the intervention and control conditions compared to dichotomous measures.

  2. Treatment decision

    Time frame: Assessment 3 months after the participants receive the decision aid

    Secondary outcome is treatment decision (number of patients that choose surgery and number of patients that choose wait-and-see)

Study contacts

Contact information is provided by the study sponsor or research team.

Monique Chambon, PhD

CONTACT

[email protected]

+31 (0)20 525 5340

Sponsors and collaborators

Lead sponsor

University of Amsterdam

Other

Collaborators

  • Leiden University Medical Center
  • Radboud University Medical Center

Registry information

Important dates

Study start
2026
Primary completion
2027
Study completion
2027
First posted
Apr 1, 2026
Registry last updated
Apr 1, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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