Decision Aids for Patients.

Background: Patients want to be more involved in medical decision-making. To this end, some decision aids are now available. Methods: We present an overview of this subject, in which we explain the terms "shared decision-making", "decision aid", and "evidence- based patient information" and survey i...

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Publicado en:Deutsches Ärzteblatt International Vol. 109; no. 22/23; pp. 401 - 409
Autores principales: Lenz, Matthias, Buhse, Susanne, Kasper, Jürgen, Kupfer, Ramona, Richter, Tanja, Mühlhauser, Ingrid
Formato: research systematic review tables/charts Journal Article
Publicado: Deutscher Aerzte-Verlag GmbH 6/4/2012
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Decision Aids for Patients.
      aug:
        au:
          Lenz, Matthias
          Buhse, Susanne
          Kasper, Jürgen
          Kupfer, Ramona
          Richter, Tanja
          Mühlhauser, Ingrid
        affil: Hamburg University, School of Mathematics, Informatics and Natural Sciences, Unit of Health Sciences and Education; University Medical Center Hamburg-Eppendorf, Department of Primary Medical Care
      sug:
        subj:
          Decision Support Techniques Classification
          Decision Making, Patient
          Human
          Germany
          Medline
          Embase
          Psycinfo
          Cochrane Library
          Randomized Controlled Trials
          World Wide Web
          Multiple Sclerosis
          Cancer Screening
      ab: Background: Patients want to be more involved in medical decision-making. To this end, some decision aids are now available. Methods: We present an overview of this subject, in which we explain the terms "shared decision-making", "decision aid", and "evidence- based patient information" and survey information on the available decision aids in German and other languages on the basis of a literature search in MEDLINE, EMBASE and PsycInfo and a current Cochrane Review. We also searched the Internet for providers of decision aids in Germany. Results: Decision aids exist in the form of brochures, decision tables, videos, and computer programs; they address various topics in the prevention, diagnosis, and treatment of disease. They typically contain information on the advantages and disadvantages of the available options, as well as guidance for personal decision-making. They can be used alone or as a part of structured counseling or patient education. Minimal quality standards include an adequate evidence base, completeness, absence of bias, and intelligibility. Our search revealed 12 randomized controlled trials (RCTs) of decision aids in German and 106 RCTs of decision aids in other languages. These trials studied the outcome of the use of decision aids not just with respect to clinical developments, but also with respect to patient knowledge, adherence to treatment regimens, satisfaction, involvement in decision-making, autonomy preference, and decisional conflicts. Conclusion: Only a small fraction of the available decision aids were systematically developed and have been subjected to systematic evaluation. Patients are still not receiving the help in decision-making to which medical ethics entitles them. Structures need to be put in place for the sustainable development, evaluation and implementation of high-quality decision aids.
      pubtype: Academic Journal
      doctype:
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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