Are Patient Decision Aids Used in Clinical Practice after Rigorous Evaluation? A Survey of Trial Authors.
Background. Patient decision aids (PtDAs) are effective interventions to support patient involvement in health care decisions, but there is little use in practice. Our study aimed to determine subsequent PtDA use in clinical practice following published randomized controlled trials. Design. A descri...
| Published in: | Medical Decision Making Vol. 39; no. 7; pp. 805 - 816 |
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| Main Authors: | , , , , , |
| Format: | research tables/charts Journal Article |
| Published: |
Sage Publications Inc.
Oct2019
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=139566471&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 139566471 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0272989X DKI jtl: Medical Decision Making issn: 0272989X maglogo: Y pubinfo: dt: Oct2019 vid: 39 iid: 7 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 139566471 139566471 139566471 10.1177/0272989X19868193 139566471 ppf: 805 ppct: 11 formats: tig: atl: Are Patient Decision Aids Used in Clinical Practice after Rigorous Evaluation? A Survey of Trial Authors. aug: au: Stacey, Dawn Suwalska, Victoria Boland, Laura Lewis, Krystina B. Presseau, Justin Thomson, Richard affil: University of Ottawa, Ottawa, ON, Canada sug: subj: Randomized Controlled Trials Decision Making, Patient Decision Support Systems, Clinical Utilization Implementation Science Human Descriptive Research Questionnaires Content Analysis Scales Health Care Delivery, Integrated Professional Role Authors ab: Background. Patient decision aids (PtDAs) are effective interventions to support patient involvement in health care decisions, but there is little use in practice. Our study aimed to determine subsequent PtDA use in clinical practice following published randomized controlled trials. Design. A descriptive study using an e-mail-embedded questionnaire survey targeting authors of 133 trials included in Cochrane Reviews of PtDAs (106 authors). We classified PtDA level of use as a) implementation, defined as integrating within care processes; b) dissemination to target users with planned strategies; and c) diffusion, defined as passive, unplanned spread. We conducted content analysis to identify barriers and enablers guided by the Ottawa Model of Research Use. Results. Ninety-eight authors responded (92.5%) on 108 trialed PtDAs. Reported levels of use were implementation (n = 29; 28%), dissemination to target user(s) (n = 9; 9%), and diffusion (n = 7; 7%); 57 (55%) reported no uptake, and 1 had no response (1%). Barriers to use in clinical practice were identified at the level of researchers (e.g., lack of posttrial plan), PtDAs (e.g., outdated, delivery mechanism), clinicians (e.g., disagreed with PtDA use), and practice environment (e.g., infrastructure support; funding). Enablers were online delivery, organizational endorsement (e.g., professional organization, charity, government), and design for and integration into the care process. Limitations. Self-report bias and potential for recall bias. Conclusions. Only 44% of PtDA trial authors indicated some level of subsequent use following their trial. The most commonly reported barriers were lack of funding, outdated PtDAs, and clinician disagreement with PtDA use. To improve subsequent use, researchers should codesign PtDAs with end users to ensure fit with clinical practice and develop an implementation plan. National systems (e.g., platforms, endorsement, funding) can enable use. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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