scholarly journals Promoting Informed Decision-Making in a Primary Care Practice by Implementing Decision Aids

2009 ◽  
Vol 70 (2) ◽  
pp. 136-139
Author(s):  
Carmen L. Lewis ◽  
Michael P. Pignone
Keyword(s):  
Primary Care ◽  
Decision Making ◽  
Primary Care Practice ◽  
Decision Aids ◽  
Informed Decision ◽  
Care Practice ◽  
Informed Decision Making

Facilitators and Barriers to Implementing a Digital Informed Decision Making Tool in Primary Care: A Qualitative Study

2022 ◽  
Vol 13 (01) ◽  
pp. 001-009
Author(s):  
Nicole Puccinelli-Ortega ◽  
Mark Cromo ◽  
Kristie L. Foley ◽  
Mark B. Dignan ◽  
Ajay Dharod ◽  
...  
Keyword(s):  
Primary Care ◽  
Decision Making ◽  
Qualitative Study ◽  
Decision Aids ◽  
Informed Decision ◽  
Care Practice ◽  
Informed Decision Making ◽  
Structured Interviews ◽  
Clinic Staff ◽  
Facilitators And Barriers

Abstract Background Informed decision aids provide information in the context of the patient's values and improve informed decision making (IDM). To overcome barriers that interfere with IDM, our team developed an innovative iPad-based application (aka “app”) to help patients make informed decisions about colorectal cancer screening. The app assesses patients' eligibility for screening, educates them about their options, and empowers them to request a test via the interactive decision aid. Objective The aim of the study is to explore how informed decision aids can be implemented successfully in primary care clinics, including the facilitators and barriers to implementation; strategies for minimizing barriers; adequacy of draft training materials; and any additional support or training desired by clinics. Design This work deals with a multicenter qualitative study in rural and urban settings. Participants A total of 48 individuals participated including primary care practice managers, clinicians, nurses, and front desk staff. Approach Focus groups and semi-structured interviews, with data analysis were guided by thematic analysis. Key Results Salient emergent themes were time, workflow, patient age, literacy, and electronic health record (EHR) integration. Saving time was important to most participants. Patient flow was a concern for all clinic staff, and they expressed that any slowdown due to patients using the iPad module or perceived additional work to clinic staff would make staff less motivated to use the program. Participants voiced concern about older patients being unwilling or unable to utilize the iPad and patients with low literacy ability being able to read or comprehend the information. Conclusion Integrating new IDM apps into the current clinic workflow with minimal disruptions would increase the probability of long-term adoption and ultimate sustainability. NIH trial registry number R01CA218416-A1.

scholarly journals A referral aid for smoking cessation interventions in primary care: study protocol for a randomized controlled trial

2021 ◽  
Vol 22 ◽  
Author(s):  
Daniëlle N. Zijlstra ◽  
Jean W.M. Muris ◽  
Catherine Bolman ◽  
J. Mathis Elling ◽  
Vera E.R.A. Knapen ◽  
...  
Keyword(s):  
Primary Care ◽  
Decision Making ◽  
Smoking Cessation ◽  
Cost Effectiveness ◽  
Structural Equation ◽  
Controlled Trial ◽  
Linear Regression Analysis ◽  
Informed Decision ◽  
Equation Modeling ◽  
Informed Decision Making

Abstract Background: To expedite the use of evidence-based smoking cessation interventions (EBSCIs) in primary care and to thereby increase the number of successful quit attempts, a referral aid was developed. This aid aims to optimize the referral to and use of EBSCIs in primary care and to increase adherence to Dutch guidelines for smoking cessation. Methods: Practice nurses (PNs) will be randomly allocated to an experimental condition or control condition, and will then recruit smoking patients who show a willingness to quit smoking within six months. PNs allocated to the experimental condition will provide smoking cessation guidance in accordance with the referral aid. Patients from both conditions will receive questionnaires at baseline and after six months. Cessation effectiveness will be tested via multilevel logistic regression analyses. Multiple imputations as well as intention to treat analysis will be performed. Intervention appreciation and level of informed decision-making will be compared using analysis of (co)variance. Predictors for appreciation and informed decision-making will be assessed using multiple linear regression analysis and/or structural equation modeling. Finally, a cost-effectiveness study will be conducted. Discussion: This paper describes the study design for the development and evaluation of an information and decision tool to support PNs in their guidance of smoking patients and their referral to EBSCIs. The study aims to provide insight into the (cost) effectiveness of an intervention aimed at expediting the use of EBSCIs in primary care.

Measuring Informed Decision Making about Prostate Cancer Screening in Primary Care

2011 ◽  
Vol 32 (2) ◽  
pp. 327-336 ◽  
Author(s):  
Amy Leader ◽  
Constantine Daskalakis ◽  
Clarence H. Braddock ◽  
Elisabeth J. S. Kunkel ◽  
James R. Cocroft ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Primary Care ◽  
Decision Making ◽  
Cancer Screening ◽  
Prostate Cancer Screening ◽  
Informed Decision ◽  
Informed Decision Making

scholarly journals End-user involvement in developing and field testing an online contraceptive decision aid

2018 ◽  
Vol 6 ◽  
pp. 205031211880946
Author(s):  
Truus Hooiveld ◽  
Joyce M Molenaar ◽  
Claudia M van der Heijde ◽  
Frans J Meijman ◽  
Theo P Groen ◽  
...  
Keyword(s):  
Decision Making ◽  
Needs Assessment ◽  
Field Test ◽  
Decision Aid ◽  
Decision Aids ◽  
User Involvement ◽  
Field Testing ◽  
End Users ◽  
Informed Decision ◽  
Informed Decision Making

Objectives: Decision aids in the field of healthcare contribute to informed decision making. To increase the usefulness and effectiveness of decision aids, it is important to involve end-users in the development of these tools. This article reports on the development of an online contraceptive decision aid. Methods: An exploratory, qualitative study was conducted in the Netherlands between 2014 and 2016. The development process of the decision aid consisted of six steps and included a needs assessment and field test. Interviews were conducted with 17 female students. Results: The needs assessment provided information on the preferred content and structure of a contraceptive decision aid and guided the development of the online contraceptive decision aid prototype. Participants had an overall positive impression of the decision aid prototype during the field test. Minor revisions were made based on participants’ feedback. Participants expected that the decision aid would positively contribute to decision making by increasing knowledge and awareness regarding the available contraceptive methods and their features and attributes, and by opening up to other options than the known methods. Conclusion: The developed contraceptive decision aid can contribute to better informed decision making and consultation preparation. Involving end-users in development seems valuable to adapt decision aids to specific needs and to identify in what way a decision aid influences decision making.

Decision Aids in the United States: the Patient Response

2015 ◽  
Vol 5 (3) ◽  
pp. 105-111
Author(s):  
Richard Wexler ◽  
Bethany S. Gerstein ◽  
Charles Brackett ◽  
Lyle J. (LJ) Fagnan ◽  
Kathleen M. Fairfield ◽  
...  
Keyword(s):  
United States ◽  
Primary Care ◽  
Decision Making ◽  
Formal Education ◽  
Decision Aids ◽  
Clinical Information ◽  
The United States ◽  
Care Practice ◽  
Or Education ◽  
Patient Response

Background:  In the United States and elsewhere, a growing chorus of voices is calling for the routine use of patient decision aids (DAs) and shared decision making (SDM) in day-to-day care.  A frequently cited barrier to this approach is the belief that many patients will not be able to understand key clinical information and/or prefer to delegate decision making to providers.  These beliefs, often held by providers, are thought to be particularly applicable to elderly and less educated patients.Objectives: To test the perception that older and less educated patients will not value or benefit from DAs.Research design: Self-administered questionnaires completed by patients after viewing DAs.Subjects: 3001 patients in six primary care practice sites facing one of sixteen common medical decisions.Measures: Amount of DA viewed, knowledge about medical tests or treatments, DA rating, and importance of receiving DAs from providers.Results: Across age and education level, higher self-reported exposure to the DAs was associated with higher knowledge scores. Those over 65 and those who had not attended college had knowledge gains at least has high as those in other groups. There were no statistically significant differences by age or education in patient assessment of the importance of using DAs.Conclusions: Patients in primary care settings in the U.S. learn from DAs, rate them highly, and believe that providers should make them available in ways that are mainly independent of patient age or formal education.

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