Patient decision aids and outcomes of its performance into routine clinical settings: A review article
Advances in Nursing & Midwifery,
Vol. 25 No. 89 (2016),
8 July 2016
,
Page 11-20
Abstract
Abstract:
Background and aim:
One of the basic principle of patient protection is the patient's right to make decisions for their health. Over two
decades, results of the studies have showed the positive effects of patient participation in decisions about their treatment
and application of "patient decision aid". But so far, the impact of implementing of these interventions in routine
practice in clinical settings, is not clear. The aim of this study was to analyze the findings of published studies that
investigated the effectiveness of strategies, methods or approaches to implement IDES into routine clinical settings.
Materials and methods:
This is a review article. Electronic resources and databases such as CINAHL, Embase, Medline, Scopus, Science
Direct, MD Consult, OVID and Google Scholar were searched to find all studies that have investigated various aspects
of the subject of "patient decision aids".
Findings:
There are significant challenges to the implementation of patient decision support. The study results showed
indifference and noncooperation between health professionals. The noncooperation was stemmed in lack of confidence
in the content of IDEs and concerns about disruption of workflows.
Conclusion:
It is too soon to make firm recommendations about the best way of implementation of patient decision support methods
into routine practice. Because teams that use this model consistently report difficulties. It seems that the major problems
against the use of these interventions are their limit implementation and they need further and special investigation.
Keywords:
Decision-Making; Decision Support Techniques; Patient Outcome Assessment
- Decision-Making
- Decision Support Techniques
- Patient Outcome Assessment
How to Cite
References
Belkora J K, Loth M K, Volz S and Rugo H S (2009) Implementing decision and communication aids to
facilitate patient-centered care in breast cancer: a case study. Patient Education and Counseling. 77 (3)
-368.
- Belkora J K, Teng A, Volz S, Loth M K and Esserman L J (2011) Expanding the reach of decision and
communication aids in a breast care center: a quality improvement study. Patient Education and
Counseling. 83 (2) 234-239.
- Brackett C, Kearing S, Cochran N, Tosteson A N and Brooks W B (2010) Strategies for distributing cancer
screening decision aids in primary care. Patient Education and Counseling. 78 (2) 166-168.
- Caldon L J, Collins K A, Reed M W, Sivell S, Austoker J, Clements A M, Patnick J and Elwyn G (2011)
Clinicians’ concerns about decision support interventions for patients facing breast cancer surgery
options: understanding the challenge of implementing shared decision‐making. Health Expectations. 14
(2) 133-146.
- Charles C, Gafni A and Whelan T (2004) Self‐reported use of shared decision‐making among breast cancer
specialists and perceived barriers and facilitators to implementing this approach. Health Expectations. 7
(4) 338-348.
- Couët N, Desroches S, Robitaille H, Vaillancourt H, Leblanc A, Turcotte S, Elwyn G and Légaré F (2013)
Assessments of the extent to which health‐care providers involve patients in decision making: a
systematic review of studies using the OPTION instrument. Health Expectations. 18 (4) 542-61.
- Damschroder L J, Aron D C, Keith R E, Kirsh S R, Alexander J A and Lowery J C (2009) Fostering
implementation of health services research findings into practice: a consolidated framework for
advancing implementation science. Implementation Science. 4 (1) 50.
- Edwards A, Elwyn G, Hood K, Atwell C, Robling M, Houston H, Kinnersley P, Russell I and Group S S
(2004) Patient-based outcome results from a cluster randomized trial of shared decision making skill
development and use of risk communication aids in general practice. Family Practice. 21 (4) 347-354.
- Elwyn G, Frosch D, Volandes A E, Edwards A and Montori V M (2010) Investing in deliberation: a
definition and classification of decision support interventions for people facing difficult health decisions.
Medical Decision Making. 30 (6) 701-711.
- Elwyn G, Frosch D, Thomson R, Joseph-Williams N, Lloyd A, Kinnersley P, Cording E, Tomson D, Dodd
C and Rollnick S (2012) Shared decision making: a model for clinical practice. Journal of General
Internal medicine. 27 (10) 1361-1367.
- Feibelmann S, Yang T S, Uzogara E E and Sepucha K (2011) What does it take to have sustained use of
decision aids? A programme evaluation for the Breast Cancer Initiative. Health Expectations. 14 (s1) 85-95.
- Frosch D L, Légaré F and Mangione C M (2008) Using decision aids in community-based primary care: a
theory-driven evaluation with ethnically diverse patients. Patient Education and Counseling. 73 (3) 490-496.
- Frosch D L, Singer K J and Timmermans S (2011) Conducting implementation research in communitybased
primary care: a qualitative study on integrating patient decision support interventions for cancer
screening into routine practice. Health Expectations. 14 (s1) 73-84.
- Gravel K, Légaré F and Graham I D (2006) Barriers and facilitators to implementing shared decisionmaking
in clinical practice: a systematic review of health professionals' perceptions. Implementation
Science. 1 (1) 16.
- Greenhalgh T, Robert G, Macfarlane F, Bate P and Kyriakidou O (2004) Diffusion of innovations in
service organizations: systematic review and recommendations. Milbank Quarterly. 82 (4) 581-629.
- Grol R and Wensing M (2004) What drives change? Barriers to and incentives for achieving evidencebased
practice. Medical Journal of Australia. 180 (6 Suppl) S57.
- Holmes-Rovner M, Kelly-Blake K, Dwamena F, Dontje K, Henry R C, Olomu A, Rovner D R and Rothert
M L (2011) Shared decision making guidance reminders in practice (SDM-GRIP). Patient Education and
Counseling. 85 (2) 219-224.
- Holmes‐Rovner M, Valade D, Orlowski C, Draus C, Nabozny‐Valerio B and Keiser S (2000)
Implementing shared decision‐making in routine practice: barriers and opportunities. Health
Expectations. 3 (3) 182-191.
- Hooshmand A, Joolaee S, Mehrdad N and Bahrani N (2006) [Nurses’ information and their view points
about patient’s rights and practical facilitators in clinics]. Hayat. 12 (4) 57-66. (Persian)
- Jafari Tabar H (2005) [The physician's civil liability]. edition. Tehran, Baraye Farda Publication.(Persian)
- Légaré F, Ratté S, Gravel K and Graham I D (2008) Barriers and facilitators to implementing shared
decision-making in clinical practice: update of a systematic review of health professionals’ perceptions.
Patient Education and Counseling. 73 (3) 526-535.
- Légaré F, Ratté S, Stacey D, Kryworuchko J, Gravel K, Graham I D and Turcotte S (2010) Interventions
for improving the adoption of shared decision making by healthcare professionals. The Cochrane Library.
(5) CD006732.
- Levine M N, Gafni A, Markham B and MacFarlane D (1992) A bedside decision instrument to elicit a
patient's preference concerning adjuvant chemotherapy for breast cancer. Annals of Internal Medicine.
(1) 53-58.
- McCaffery K, Irwig L and Bossuyt P (2007) Patient decision aids to support clinical decision making:
evaluating the decision or the outcomes of the decision. Medical Decision Making. 27 (5) 619-625.
- Miller K M, Brenner A, Griffith J M, Pignone M P and Lewis C L (2012) Promoting decision aid use in
primary care using a staff member for delivery. Patient Education and Counseling. 86 (2) 189-194.
- O'Connor A M and Stacey D (2005) Should patient decision aids (PtDAs) be introduced in the health care
system? edition. WHO Regional Office for Europe.(
- O'Neill O (2003) Some limits of informed consent. Journal of Medical Ethics. 29 (1) 4-7.
- Rabin B A, Brownson R C, Haire-Joshu D, Kreuter M W and Weaver N L (2008) A glossary for
dissemination and implementation research in health. Journal of Public Health Management and Practice.
(2) 117-123.
- Silvia K A and Sepucha K R (2006) Decision aids in routine practice: lessons from the breast cancer
initiative. Health Expectations. 9 (3) 255-264.
- Silvia K A, Ozanne E M and Sepucha K R (2008) Implementing breast cancer decision aids in community
sites: barriers and resources. Health Expectations. 11 (1) 46-53.
- Stacey D, Graham I D, O'Connor A M and Pomey M P (2005) Barriers and Facilitators Influencing Call
Center Nurses' Decision Support for Callers Facing Values‐Sensitive Decisions: A Mixed Methods Study.
Worldviews on Evidence‐Based Nursing. 2 (4) 184-195.
- Stacey D, O'Connor A M, Graham I D and Pomey M-P (2006) Randomized controlled trial of the
effectiveness of an intervention to implement evidence-based patient decision support in a nursing call
centre. Journal of Telemedicine and Telecare. 12 (8) 410-415.
- Stacey D, Chambers S K, Jacobsen M J and Dunn J. Overcoming barriers to cancer-helpline professionals
providing decision support for callers: an implementation study. In: Overcoming barriers to cancerhelpline
professionals providing decision support for callers: an implementation study. Oncology Nursing
Forum. Year P: 961-969.(
- Stacey D, Bennett C L, Barry M J, Col N F, Eden K B, Holmes-Rovner M, Llewellyn-Thomas H, Lyddiatt
A, Légaré F and Thomson R (2011) Decision aids for people facing health treatment or screening
decisions. Cochrane Database Systematic Review. 5 (10) CD001431.
- Uy V, May S G, Tietbohl C and Frosch D L (2014) Barriers and facilitators to routine distribution of
patient decision support interventions: a preliminary study in community‐based primary care settings.
Health Expectations. 17 (3) 353-364.
- Yoder-Wise P S (2004) Leading and managing in nursing. 3th edition. St. Louis, Mo., Mosby/Elsevier.
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