scholarly journals Health technology assessment–based development of a Spanish breast cancer patient decision aid

2011 ◽  
Vol 27 (4) ◽  
pp. 363-368 ◽  
Author(s):  
Fátima Izquierdo ◽  
Javier Gracia ◽  
Mercedes Guerra ◽  
Juan Antonio Blasco ◽  
Elena Andradas

Objectives: The aim of this study was to develop a breast cancer Patient Decision Aid (PDA), using a Health Technology Assessment (HTA) process, to assist patients in their choice of therapeutic options, and to promote shared decision making among patients, healthcare professionals, and other interested parties.Methods: A systematic review (SR) was conducted of existing breast cancer patient Decision Aids encountered in the main scientific journal databases and on institutional Web sites that create PDAs, together with a Qualitative Research (QR) study, using semi-structured interviews and focus group with stakeholders (patients, family members, and health professionals), with the aim of developing a PDA for breast cancer.Results: The SR shows that PDAs in breast cancer not only increase patient knowledge of the illness, leading to more realistic expectations of treatment outcomes, but also reduce passivity in the decision-making process and facilitate the appropriate choice of treatment options in accordance with patient medical and personal preferences. The analysis of QR shows that both breast cancer patients and healthcare professionals agree that surgery, adjuvant treatments, and breast reconstruction represent the most important decisions to be made. Worry, anxiety, optimism, and trust in healthcare professionals were determined as factors that most affected patients subjective experiences of the illness. This HTA was used as the basis for developing a PDA software program.Conclusions: The SR and QR used in the development of this PDA for breast cancer allowed patients to access information, gain additional knowledge of their illness, make shared treatment decisions, and gave healthcare professionals a deeper insight into patient experiences of the disease.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
I. E. H. Kremer ◽  
P. J. Jongen ◽  
S. M. A. A. Evers ◽  
E. L. J. Hoogervorst ◽  
W. I. M. Verhagen ◽  
...  

Abstract Background Since decision making about treatment with disease-modifying drugs (DMDs) for multiple sclerosis (MS) is preference sensitive, shared decision making between patient and healthcare professional should take place. Patient decision aids could support this shared decision making process by providing information about the disease and the treatment options, to elicit the patient’s preference and to support patients and healthcare professionals in discussing these preferences and matching them with a treatment. Therefore, a prototype of a patient decision aid for MS patients in the Netherlands—based on the principles of multi-criteria decision analysis (MCDA) —was developed, following the recommendations of the International Patient Decision Aid Standards. MCDA was chosen as it might reduce cognitive burden of considering treatment options and matching patient preferences with the treatment options. Results After determining the scope to include DMDs labelled for relapsing-remitting MS and clinically isolated syndrome, users’ informational needs were assessed using focus groups (N = 19 patients) and best-worst scaling surveys with patients (N = 185), neurologists and nurses (N = 60) to determine which information about DMDs should be included in the patient decision aid. Next, an online format and computer-based delivery of the patient decision aid was chosen to enable embedding of MCDA. A literature review was conducting to collect evidence on the effectiveness and burden of use of the DMDs. A prototype was developed next, and alpha testing to evaluate its comprehensibility and usability with in total thirteen patients and four healthcare professionals identified several issues regarding content and framing, methods for weighting importance of criteria in the MCDA structure, and the presentation of the conclusions of the patient decision aid ranking the treatment options according to the patient’s preferences. Adaptations were made accordingly, but verification of the rankings provided, validation of the patient decision aid, evaluation of the feasibility of implementation and assessing its value for supporting shared decision making should be addressed in further development of the patient decision aid. Conclusion This paper aimed to provide more transparency regarding the developmental process of an MCDA-based patient decision aid for treatment decisions for MS and the challenges faced during this process. Issues identified in the prototype were resolved as much as possible, though some issues remain. Further development is needed to overcome these issues before beta pilot testing with patients and healthcare professionals at the point of clinical decision-making can take place to ultimately enable making conclusions about the value of the MCDA-based patient decision aid for MS patients, healthcare professionals and the quality of care.


2020 ◽  
Vol 103 (1) ◽  
pp. 145-151
Author(s):  
Linda A. Klaassen ◽  
Jolanda H.H.M. Friesen-Storms ◽  
Gerrie J.J.W. Bours ◽  
Carmen D. Dirksen ◽  
Liesbeth J. Boersma ◽  
...  

Vestnik ◽  
2021 ◽  
pp. 315-323
Author(s):  
Л.К. Кошербаева ◽  
З.Р. Сагындыкова ◽  
Т.Б. Егеубаев

В условиях ограниченных бюджетов для современного здравоохранения рациональное потребление ресурсов является очень актуальной проблемой. Оценка технологий здравоохранения (ДСТБ) - комплексная оценка относительно доказанной клинической и клинико-экономической (фармаколого-экономической) эффективности и безопасности технологий здравоохранения, а также экономических, социальных и этических последствий их применения. Цель оценки технологий здравоохранения-одобрение заявленных технологий здравоохранения и включение заявленных технологий здравоохранения в перечень компенсации и информирование политиков в области здравоохранения. Следует ли применять здоровье сберегающую технологию, как ее применять и какую пользу от нее получают пациенты. Обучение экспертным знаниям о выживаемости, диагностике и лечении болезней и болезней, в том числе о методе оказания помощи (для анализа затрат и выгод), бремени болезней, выявлении пробелов в уходе, выявлении и удовлетворении потребностей. Предоставление отзывов о лечении (или отсутствии лечения и поддержки) социальных последствий заболевания способствует подходу пациентов, процессу принятия решений по мере необходимости. In the context of limited budgets for modern healthcare, rational resource consumption is a very urgent problem. Health Technology Assessment (OST) - a comprehensive assessment of the relatively proven clinical and clinical- economic (pharmacological-economic) effectiveness and safety of health technologies, as well as the economic, social and ethical consequences of their use. The purpose of the health technology assessment is to approve the claimed health technologies and include the claimed health technologies in the compensation list and inform health policy makers. It shows whether healthcare technology should be used or not, how it should be used, and how patients can benefit from it. Providing expert knowledge on the pain and burden of living, diagnosis and treatment, including the method of providing assistance (to analyze costs and benefits), the burden of diseases, identifying gaps in care, identifying and meeting needs. Giving feedback on the treatment (or lack of treatment and support) of the social consequences of the disease contributes to the decision-making process depending on the patient's attitude, needs.


2021 ◽  
Vol 16 (1) ◽  
pp. 76-108
Author(s):  
Ayeshah Syed

The Candlin Researcher AwardThe low uptake of insulin leaves many Malaysians with type 2 diabetes at risk of developing complications. To improve decision making about insulin treatment, a patient decision aid (PDA) was developed for use with patients. However, although it is generally accepted that PDAs can support informed and shared decision making, there is limited discursive data showing how they are used in doctor–patient consultations. This paper reports on activity analysis of clinic consultations in which a PDA about insulin treatment was used. Eleven consultations with diverse participants conducted in three healthcare settings in Malaysia were systematically mapped to identify structural, interactional and thematic patterns. Two main phases of Assessment and Treatment were identified, with doctors generally participating more than patients. Mapping of the Treatment phase showed that structural patterns depended on two main factors: whether patients had read the PDA and whether they responded negatively or positively towards insulin. While mapping is only a preliminary stage of activity analysis, the findings offer insights into structural, interactional and thematic patterns in PDA use at the level of the whole consultation. They also point towards key areas for closer analysis of discursive practices.


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