Interprofessional-Shared Decision Making for Pregnant Women w ith Opioid Use: Results from a Provider Training

IntroductionOpioid use disorder (OUD) is characterised by the fifth Edition of the Diagnostic and Statistics Manual as a problematic pattern of opioid use (eg, fentanyl, heroin, oxycodone) that leads to clinically significant impairment. OUD diagnoses have risen substantially over the last decade, and treatment services have struggled to meet the demand. Evidence suggests when patients with chronic illnesses are matched with their treatment preferences and engaged in shared decision-making (SDM), health outcomes may improve. However, it is not known whether SDM could impact outcomes in specific substance use disorders such as OUD.Methods and analysisA scoping review will be conducted according to Arksey and O’Malley’s framework and by recommendations from Levacet al. The search strategy was developed to retrieve relevant publications from database inception and June 2017. MEDLINE, EMBASE, PsycINFO, Cochrane Database for Controlled Trials, Cochrane Database for Systematic Reviews and reference lists of relevant articles and Google Scholar will be searched. Included studies must be composed of adults with a diagnosis of OUD, and investigate SDM or its constituent components. Experimental, quasi-experimental, qualitative, case–control, cohort studies and cross-sectional surveys will be included. Articles will be screened for final eligibility according to title and abstract, and then by full text. Two independent reviewers will screen excluded articles at each stage. A consultation phase with expert clinicians and policy-makers will be added to set the scope of the work, refine research questions, review the search strategy and identify additional relevant literature. Results will summarise whether SDM impacts health and patient-centred outcomes in OUD.Ethics and disseminationScoping review methodology is considered secondary analysis and does not require ethics approval. The final review will be submitted to a peer-reviewed journal, disseminated at relevant academic conferences and will be shared with policy-makers, patients and clinicians.

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Treatment options and shared decision-making in the treatment of opioid use disorder: A scoping review

Journal of Substance Abuse Treatment ◽

10.1016/j.jsat.2021.108646 ◽

2021 ◽

pp. 108646

Author(s):

Tyler Marshall ◽

Myles Hancock ◽

Elizabeth N. Kinnard ◽

Karin Olson ◽

Adam Abba-Aji ◽

...

Keyword(s):

Decision Making ◽

Shared Decision Making ◽

Scoping Review ◽

Treatment Options ◽

Opioid Use Disorder ◽

Shared Decision ◽

Opioid Use

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Effect of shared decision making on mode of delivery and decisional conflict and regret in pregnant women with previous cesarean section: a randomized clinical trial

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03615-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Fatemeh Hadizadeh-Talasaz ◽

Faezeh Ghoreyshi ◽

Fatemeh Mohammadzadeh ◽

Roghaieh Rahmani

Keyword(s):

Decision Making ◽

Cesarean Section ◽

Pregnant Women ◽

Shared Decision Making ◽

Mode Of Delivery ◽

Decisional Conflict ◽

Control Group ◽

Shared Decision ◽

Previous Cesarean Section ◽

Previous Cesarean

Abstract Background The promotion of vaginal birth after cesarean section (VBAC) is the best method for the reduction of repeated cesarean sections. Nonetheless, the decisional conflict which often results from inadequate patient involvement in decision making, may lead to delayed decision making and regret about the choices that were made. The present study aimed to determine the effect of shared decision making on the mode of delivery and decisional conflict and regret in pregnant women with previous cesarean section. Methods This randomized clinical trial was conducted on 78 pregnant women with a previous cesarean section referring to community health centers in Torbat-e Jam, Iran, in 2019. They were randomly assigned to two groups of intervention and control. During weeks 24-30 of pregnancy, the Decisional Conflict Scale (DCS) was completed by pregnant mothers. Apart from the routine care, the experimental group received a counseling session which was held based on the three-talk model of shared decision making. This session was moderated by a midwife; moreover, a complementary counseling session was administered by a gynecologist. During weeks 35–37 of pregnancy, DCS was completed, and the Decision Regret Scale (DRS) was filled out for both groups at the 8th weeks postpartum and they were asked about the mode of delivery. Data were analyzed in SPSS software (version 19) using the Mann-Whitney, Chi-squared and Fisher’s exact tests. p-value less than 0.05 was considered statistically significant. Results After the intervention, the decisional conflict score was significantly lower in the shared decision making (SDM) group, compared to that in the control group (14.90 ± 9.65 vs. 25.41 ± 13.38; P < 0.001). Moreover, in the SDM group, the rate of vaginal birth was significantly higher than that in the control group (P < 0.001). Two month after the delivery, the mean score of decision regret was lower in the SDM group, in comparison to that in the control group (15.67 ± 23.37 vs. 27. 30± 26.75; P = 0.007). Conclusions Based on the results of the study, shared counseling can be effective in the reduction of decisional conflict and regret, as well as rate enhancement of VBAC. Therefore, it can be concluded that this counseling method can be used in prenatal care to reduce the rate of repeated cesarean section. Trial registration IRCT20190506043499N1; Name of the registry: Iranian Registry of Clinical Trials; Registered 10. August 2019. URL of registry: https://en.irct.ir/trial/39538. Date of enrolment of the first participant to the trial: August 2019.

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Effect of Shared Decision-making on Anxiety of Women Recommended for Prenatal Screening Tests in Southeast of Iran

Journal of Family & Reproductive Health ◽

10.18502/jfrh.v14i3.4673 ◽

2020 ◽

Author(s):

Zahra Moudi ◽

Raheleh Jam ◽

Hossein Ansari ◽

Mostafa Montazer Zohour

Keyword(s):

Decision Making ◽

Pregnant Women ◽

Shared Decision Making ◽

Prenatal Screening ◽

Intervention Group ◽

Screening Tests ◽

Control Group ◽

Shared Decision ◽

Level Of Education ◽

University Level

Objective: To study the effect of shared decision-making (SDM) on the anxiety of women who were recommended for prenatal screening tests. Materials and methods: This quasi-experimental study was conducted on a total of 200 pregnant women who referred to the health centers of Zahedan, Iran, for prenatal care within April 7 to September 7, 2019. The control group received routine care, and the intervention group attended a session based on SDM. The demographic characteristics form and Spielberger Six-item State-Trait Anxiety Inventory were filled out before and immediately after the counseling, as well as before receiving the results of maternal serum biochemical markers. Results: No statistically significant effect of SDM on anxiety was reported between the control and intervention groups immediately after the counseling session (P=0.46). However, the obtained data showed that the mean value of anxiety scores (16.52±3.06) was higher among the women in the intervention group than that reported for the control group (13.80±3.55) on the day before receiving the results of the blood tests (P<0.001). Nevertheless, logistic regression analysis showed only women with a university level of education were likely to have higher anxiety scores than women with lower educational levels (AOR=10.60; 95% CI: 2.07-54.24; P=0.005). Conclusion: Offering prenatal screening can cause a slight increase in the level of anxiety among women with a university level of education. Therefore, it is required to implement supportive strategies to help high-risk pregnant women in coping with anxiety.

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Shared Decision‐Making Tool for Treatment of Perinatal Opioid Use Disorder

Psychiatric Research and Clinical Practice ◽

10.1176/appi.prcp.20180004 ◽

2019 ◽

Vol 1 (1) ◽

pp. 27-31 ◽

Cited By ~ 3

Author(s):

Constance Guille ◽

Hendree E. Jones ◽

Alfred Abuhamad ◽

Kathleen T. Brady

Keyword(s):

Decision Making ◽

Shared Decision Making ◽

Opioid Use Disorder ◽

Shared Decision ◽

Opioid Use ◽

Decision Making Tool

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A childhood immunization education program for parents delivered during late pregnancy and one-month postpartum: a randomized controlled trial

BMC Health Services Research ◽

10.1186/s12913-019-4622-z ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Hiroko Otsuka-Ono ◽

Narumi Hori ◽

Hiroshi Ohta ◽

Yukari Uemura ◽

Kiyoko Kamibeppu

Keyword(s):

Decision Making ◽

Randomized Controlled Trial ◽

Pregnant Women ◽

Shared Decision Making ◽

Education Program ◽

Controlled Trial ◽

Intervention Group ◽

Shared Decision ◽

Randomized Controlled ◽

Immunization Rates

Abstract Background Improved immunization rates have reduced the incidence of vaccine-preventable diseases (VPDs) in advanced nations. Japan’s unique vaccination system classifies vaccines into routine vaccines ostensibly required under the Preventive Vaccination Law and recommended but optional vaccines, although all vaccines are in fact voluntary. In Japan, low immunization rates, particularly for optional vaccines, have resulted in high rates of sequelae and death. The decision as to whether a child will receive a vaccine depends on the parents, who must obtain information, make inquiries, and make the required payment, the last of which is a major barrier. This randomized, controlled trial was conducted to evaluate the effectiveness of an immunization education program designed to meet mothers’ needs. Methods This randomized controlled trial assigned pregnant women to intervention or control groups. The intervention was individual education sessions involving the children’s fathers in shared decision-making on whether or not to immunize their child. A survey was conducted before and after the intervention. Data were analyzed using the intention-to-treat principle. Results Of 225 pregnant women, 175 (78%) participated and 171 replied to the post-survey. At age 3 months, intervention infants had higher self-reported immunization rates for hepatitis B virus vaccine (76% vs. 49%; P < 0.001) and rotavirus vaccine (84% vs. 68%; P = 0.019) than control group infants. The percentage of parents intending to vaccinate their infants was higher in the intervention group (77% vs. 52%; P < 0.01). Improvements in scores for basic knowledge (mean [SD]: 5.5 [3.6] vs. 3.0 [3.8], range: 10–30; P < 0.001), advanced knowledge (mean [SD]: 5.1 [2.4] vs. 2.8 [2.5], range: 5–15; P < 0.001), and health literacy regarding immunization (mean [SD]: 0.5 [0.8] vs. 0.2 [0.6], range: 1–5; P < 0.01) were higher in the intervention group. The rate of decision making by both parents (68% vs. 52%; P < 0.05) was higher in the intervention group. Conclusions Our findings confirmed the program’s effectiveness. The intervention improved immunization rates, the percentage of parents intending to vaccinate their infants and knowledge scores. Interventions which directly and indirectly involved fathers in shared decision-making on whether to immunize their child were effective, as were individualized interventions that provided parents with access to up-to-date information. Trial registration UMIN000012575. Registered 14 December 2013 (The study was prospectively registered).

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A Shared Decision-Making Toolkit for Mode of Birth After Cesarean

The Journal of Perinatal Education ◽

10.1891/1058-1243.29.1.35 ◽

2020 ◽

Vol 29 (1) ◽

pp. 35-49

Author(s):

Somphit Chinkam ◽

Courtney Steer-Massaro ◽

Karla Damus ◽

Brett Shorten ◽

Allison Shorten

Keyword(s):

Decision Making ◽

Pilot Study ◽

Pregnant Women ◽

Shared Decision Making ◽

Decision Aid ◽

Shared Decision ◽

Racially Diverse ◽

Provider Perspectives ◽

Mode Of Birth ◽

Women's Knowledge

This study evaluated a shared decision-making (SDM) Toolkit (decision aid, counseling guide, and provider scripts) designed to prepare and engage racially diverse women in shared decision-making discussions about the mode of birth after cesarean. The pilot study, involving 27 pregnant women and 63 prenatal providers, assessed women's knowledge, preferences, and satisfaction with decision making, as well as provider perspectives on the Toolkit's acceptability. Most women experienced knowledge improvement, felt more in control and that providers listened to their concerns and supported them. Providers reported that the Toolkit helped women understand their options and supported their counseling. The SDM Toolkit could be used to help women and providers improve their SDM regarding mode of birth after cesarean.

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