How "Shared Decision Making Decision-aid" Help Patients With Obstructive Sleep Apnea to Choose Treatment Plan

2019 ◽  
Author(s):  
Keyword(s):  
Decision Making ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Shared Decision Making ◽  
Decision Aid ◽  
Treatment Plan ◽  
Shared Decision ◽  
Obstructive Sleep

Shared-decision making tool for obstructive sleep apnea

2017 ◽  
Vol 40 ◽  
pp. e83-e84
Author(s):  
A. Duggins ◽  
M. Bergeron ◽  
K. Tiemeyer ◽  
L. Mullen ◽  
J. Crisalli ◽  
...  
Keyword(s):  
Decision Making ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Shared Decision Making ◽  
Shared Decision ◽  
Obstructive Sleep ◽  
Decision Making Tool

scholarly journals 0624 Voice of the Patient: A Patient-Centered Exploration of Factors Influencing Obstructive Sleep Apnea Care

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A238-A239
Author(s):  
F M Puravath ◽  
T Ash ◽  
R Rottapel ◽  
C Spadola ◽  
S Bandana ◽  
...  
Keyword(s):  
Decision Making ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Shared Decision Making ◽  
Patient Experience ◽  
Shared Decision ◽  
Patient Centered ◽  
Factors Influencing ◽  
Obstructive Sleep ◽  
Centered Care

Abstract Introduction Despite widely available efficacious treatments for obstructive sleep apnea (OSA), patients commonly report frustration in accessing and adhering to treatments. Sparse research has explored factors influencing OSA care from the patient perspective, which may limit provision of patient-centered care: care responsive to patient preferences, needs, and values. To this end, we conducted qualitative research to identify factors, voiced by patients, that influence OSA treatment initiation and adherence. Methods We performed semi-structured interviews with 15 patients previously diagnosed with OSA from Boston, MA and a national patient portal (MyApnea.Org). Patients were asked about barriers and facilitators to their diagnosis and treatment as well as about their preferences and values that informed their treatment decisions. Interviews were audio-recorded and transcribed. A qualitative content analysis was performed to identify themes. After developing a codebook, interviews were coded. Codes were then audited and finalized by study team consensus. Results Our sample was aged 25-74 years; 71% identified as female. Among participants, 57.1% identified as White, 14.3% Black, 14.3% Asian, and 14.3% Other. Major themes were broadly classified as (1) facilitators (provision of useful information on treatment options, participation in shared decision-making, continued clinician support); (2) barriers (inconvenience of treatment, difficulty of habit formation, treatment side effects, competing comorbid conditions); (3) motivators (value of improving chronic health, family support, positive treatment effects); (4) contextual factors (insufficient knowledge/awareness of OSA, navigating healthcare systems, access to informational resources). Awareness of OSA symptoms and treatments, and ongoing support were cited as the most common factors influencing the patient experience. Conclusion This formative research highlights that diverse factors impact the OSA evaluation and treatment patient experience. Further research should test interventions that promote effective patient-centered care for OSA, such as shared decision-making tools. Support Brigham and Women’s Hospital Research Institute Patient-Centered Comparative Effectiveness Research Center Grant

A shared decision-making tool for obstructive sleep apnea without tonsillar hypertrophy: A randomized controlled trial

2017 ◽  
Vol 128 (4) ◽  
pp. 1007-1015 ◽  
Author(s):  
Mathieu Bergeron ◽  
Angela L. Duggins ◽  
Aliza P. Cohen ◽  
Karin Tiemeyer ◽  
Lisa Mullen ◽  
...  
Keyword(s):  
Decision Making ◽  
Randomized Controlled Trial ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Controlled Trial ◽  
Shared Decision ◽  
Tonsillar Hypertrophy ◽  
Randomized Controlled ◽  
Obstructive Sleep ◽  
Decision Making Tool

Development of a Decision Aid for Parents Who Elect Tonsillectomy for Obstructive Sleep Apnea

2021 ◽  
pp. 000348942110371
Author(s):  
Adrian Williamson ◽  
Maxwell Newby ◽  
Drew Phillips ◽  
Michele Carr
Keyword(s):  
Decision Making ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Decision Aid ◽  
Tertiary Care ◽  
Knowledge Score ◽  
Decisional Conflict ◽  
Obstructive Sleep ◽  
Parental Treatment ◽  
The Mean

Objective: To develop a novel patient decision aid (PtDA) for parents considering tonsillectomy for their children diagnosed with obstructive sleep apnea (OSA) and compare it to validated scales related to decision making in this context. These included scales for decisional conflict (DC) and shared decision making (SDM). Methods: A parental survey during 2017 to 2018 in a tertiary care pediatric otolaryngology clinic was conducted comparing a validated Decisional Conflict Scale (DCS) with a new PtDA that included an SDM scale, parental treatment goals, and knowledge about adenotonsillectomy and OSA. DCS scores range from 0 to 100 with values less than 25 considered to be low DC. The DQ was determined by a score on the PtDA. The PtDA was composed of a knowledge score, SDM score and 5 related values scored along a continuum (these were: resolution of symptoms, avoiding anesthesia, avoiding surgery, avoiding pain/bleeding, and resumption of normal behavior). A high score meant that all answers were consistent with choosing tonsillectomy and imply better DQ. Results: A total of 89 parents or guardians participated in the study. The mean DC score was 4.32 (95% CI: 2.57-6.07). The mean DQ score was 22.69 (95% CI: 21.86-23.51). Mean values score was 5.35 (95% CI: 5.05-5.65). The mean knowledge score was 9.00 (95% CI: 8.60-9.40). SDM score mean was 8.38 (95% CI: 7.85-8.91). Using Spearman’s rho, DC versus DQ inversely correlated with a coefficient −.209 via a 2-tailed test ( P = .05). Cronbach’s alpha for the DQ score was .78. Conclusion: DC scores overall were low for the group. DQ, as measured with the novel PtDA, had an inverse correlation with DC scores, suggesting validity of the proposed PtDA. Our instrument has potential use as a PtDA for parents who are offered tonsillectomy for their children.

Use of an Atrial Fibrillation Medication Decision Aid Improves Knowledge and Process for Decision Making (Preprint)

2018 ◽  
Author(s):  
Molly Beinfeld ◽  
Suzanne Brodney ◽  
Michael Barry ◽  
Erika Poole ◽  
Adam Kunin
Keyword(s):  
Atrial Fibrillation ◽  
Decision Making ◽  
Shared Decision Making ◽  
Anticoagulant Therapy ◽  
Decision Aid ◽  
Response Rate ◽  
Intervention Group ◽  
Shared Decision ◽  
Community Based ◽  
Baseline Group

BACKGROUND A rural community-based Cardiology practice implemented shared decision making supported by an evidence-based decision aid booklet to improve the quality of anticoagulant therapy decisions in patients with atrial fibrillation. OBJECTIVE To develop a practical workflow for implementation of an anticoagulant therapy decision aid and to assess the impact on patients’ knowledge and process for anticoagulant medication decision making. METHODS The organization surveyed all patients with atrial fibrillation being seen at Copley Hospital to establish a baseline level of knowledge, certainty about the decision and process for decision making. The intervention surveys included the same knowledge, certainty, process and demographic questions as the baseline surveys, but also included questions asking for feedback on the decision aid booklet. Stroke risk scores (CHA2DS2-VASc score) were calculated by Copley staff for both groups using EMR data. RESULTS We received 46 completed surveys in the baseline group (64% response rate) and 50 surveys in the intervention group (72% response rate). The intervention group had higher knowledge score than the baseline group (3.6 out of 4 correct answers vs 3.1, p=0.036) and Decision Process Score (2.89 out of 4 vs 2.09, p=0.0023) but similar scores on the SURE scale (3.12 out of 4 vs 3.17, p=0.79). Knowledge and Process score differences were sustained even after adjusting for co-variates in stepwise linear regression analyses. Patients with high school or lower education appeared to benefit the most from shared decision making, as demonstrated by their knowledge scores. CONCLUSIONS It is feasible and practical to implement shared decision making supported by decision aids in a community-based Cardiology practice. Shared decision making can improve knowledge and process for decision making for patients with atrial fibrillation. CLINICALTRIAL None

InformedTogether: A decision aid to support shared decision making about mechanical ventilation in severe COPD patients

2018 ◽  
Author(s):  
Meliss Basile ◽  
Johanna Andrews ◽  
Sonia Jacome ◽  
Meng Zhang ◽  
Andrzej Kozikowski ◽  
...  
Keyword(s):  
Decision Making ◽  
Mechanical Ventilation ◽  
Shared Decision Making ◽  
Decision Aid ◽  
Shared Decision ◽  
Copd Patients ◽  
Severe Copd

scholarly journals Patient decision aid based on multi-criteria decision analysis for disease-modifying drugs for multiple sclerosis: prototype development

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 ◽  
...  
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Decision Aid ◽  
Healthcare Professionals ◽  
Treatment Options ◽  
Shared Decision ◽  
Patient Decision Aid ◽  
Disease Modifying Drugs ◽  
Patient Decision ◽  
Further Development

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.

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