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Development of a patient decision aid template for use in different clinical settings

Karina Olling, Troels Bechmann, Poul Henning Madsen, Erik Hugger Jakobsen, Dorte Beth Toftdahl, Ole Hilberg, Angela Coulter, Karina Dahl Steffensen

Abstract


Objective: The aim of this study was to develop and test a patient decision aid (PtDA) template that could be adapted to different clinical encounters.

Methods: A systematic development process guided by the International Patient Decision Aid Standards (IPDAS) model was adopted and a collaboration with a design school was established. Scope and purpose of prototypes were defined, steering groups were established and a PtDA template was designed. Alpha testing was conducted by structured interviews with patients and healthcare professionals.

Results: In the alpha test, 39 patients and 24 healthcare professionals participated. Patients and healthcare professionals rated the PtDA highly for usability and acceptability and the PtDAs were found suitable for preparing patients to make preference-sensitive decisions. Qualitative findings were used to refine the PtDA.

Conclusion: Using a systematic process and high user involvement we developed a PtDA template and 2 prototypes that meet the IPDAS criteria. Testing of the PtDA prototypes showed that the template can be adapted to other clinical settings without affecting the quality of the PtDA. The PtDA template will be made available in a web-based “build-your-own-PtDA” software platform, making development of PtDAs more accessible for all healthcare professionals.

Keywords


Cancer care, clinical decision-making, patient-centered care, patient-clinician partnership, patient decision aid, patient education, patient information, patient interviews, person-centered healthcare, qualitative research, shared decision-making, testin

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References


Coulter, A. & Collins, A. (2011). Making Shared Decision Making a Reality. No decision about me, without me. London: The Kings Fund.

Morgen, M. (2016). Sundhedsvæsenet - ifølge danskerne. Available at: http://mm.dk.newsite.dk/report/sundhedsvaesenet-ifoelge-danskerne-2/.

Tariman, J.D., Berry, D.L., Cochrane, B., Doorenbos, A. & Schepp, K. (2010). Preferred and actual participation roles during health care decision making in persons with cancer: a systematic review. Annals of Oncology 21 (6) 1145-1151.

Kehl, K.L., Landrum, M.B., Arora, N.K., Ganz, P.A., van Ryn, M., Mack J.W. & Keating, N.L. (2015). Association of Actual and Preferred Decision Roles With Patient-Reported Quality of Care: Shared Decision Making in Cancer Care. JAMA Oncology 1 (1) 50-58.

Lloyd, A., Joseph-Williams, N., Edwards, A., Rix, A. & Elwyn, G. (2013). Patchy ‘coherence’: using normalization process theory to evaluate a multi-faceted shared decision making implementation program (MAGIC). Implementation Science 8, 102.

Coulter, A. (2012). Patient Engagement - What Works? Journal of Ambulatory Care Management 35 (2) 80-89.

Stacey, D., Légaré, F., Lewis, K., Barry, M.J., Bennet, C.L., Eden, K.B., Holmes-Rovner, M., Llwellyn-Thomas, H., Lyddiatt, A., Thomson, R. & Trevena, L. (2017). Decision aids for people facing health treatment or screening decisions. Cochrane Database of Systematic Reviews 4: CD001431.

Danish Ministry of Health. (2016). The Patients' Cancer Plan - Cancer Plan IV. Available at: www.sum.dk.

Dahl Steffensen, K., Hjelholt Baker, V. & Vinter, M.M. (2017). Implementing shared decision making in Denmark: First steps and future focus areas. Zeitschrift für Evidenz Fortbildung und Qualitat im Gesundhwesheitswen 123-124, 36-40.

Steffensen, K.D. (2015). Program Plan - Center for Shared Decision Making - part of the Patients Cancer Hospital. Available at: http://www.cffb.dk/media/1118/cffb-programplan_light_uk_final_opdat_210116.pdf [cited 2017 november].

Steffensen, K.D., Vinter, M., Crüger, D., Dankl, K., Coulter, A., Stuart, B. & Berry, L.L. (2018). Lessons in Integrating Shared Decision-Making Into Cancer Care. Journal of Oncology Practice 14 (4) 229-235.

Coulter, A., Stilwell, D., Kryworuchko, J., Mullen, P.D., Ng, C.J. & van der Weijden, T. (2013). A systematic development process for patient decision aids. BMC Medical Informatics and Decision Making 13 (Supplement 2) S2.

Elwyn, G., et al. (2006). Developing a quality criteria framework for patient decision aids: online international Delphi consensus process. British Medical Journal 333 (7565) 417.

Montori, V.M., Kunneman, M. & Brito, J.P. (2017). The answer is not in. Journal of the American Medical Association 318 (7) 617-618.

Stacey, D., Légaré, F., Lyddiatt, A., Giguere, A.M., Yoganathan, M., Saarimaki, A., Pardo, J.P., Rader, T. & Tugwell, P. (2016). Translating Evidence to Facilitate Shared Decision Making: Development and Usability of a Consult Decision Aid Prototype. Patient 9 (6) 571-582.

Bennett, C., Graham, I.D., Kristjansson, E., Kearing, S.A., Clay, K.F. & O'Connor, A.M. (2010). Validation of a preparation for decision making scale. Patient Education and Counseling 78 (1) 130-133.

Barry, M.J., Cherkin, D.C., Chang, Y., Fowler, F.J. & Skates, S. (1997). A randomized trial of a multi-media shared decision making program for men facing a treatment decision for benign prostatic hyperplasia. Disease Management and Clinical Outcomes 1 (1) 5-14.

Kushniruk, A.W. & Patel, V.L. (2004). Cognitive and usability engineering methods for the evaluation of clinical information systems. Journal of Biomedical Informatics 37 (1) 56-76.

WHO. (2017). Process of translation and adaptation of instruments. Available at: www.who.int/substance_abuse/research_tools/translation/en/. (Cited 3/11/17).

Graham, I.D. & O'Connor, A.M. (1995). User manual - Preparation for Decision Making Scale. Available at: www.ohri.ca/decisionaid. (Cited 3/11/17).

Ottawa Hospital Research Insititute. (2015). Patient Decision Aids. Available at: https://decisionaid.ohri.ca. (Cited 27/12/17).




DOI: http://dx.doi.org/10.5750/ejpch.v7i1.1588

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