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The impact of a patient decision aid on shared decision‐making behaviour in oncology care and pulmonary medicine—A field study based on real‐life observations
Author(s) -
Olling Karina,
Stie Mette,
Winther Bodil,
Steffensen Karina Dahl
Publication year - 2019
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/jep.13196
Subject(s) - medicine , observational study , decision aids , breast cancer , cohort , cohort study , family medicine , preference , intervention (counseling) , lung cancer , cancer , medical physics , oncology , nursing , alternative medicine , pathology , economics , microeconomics
Objective A patient decision aid (PtDA) is often developed and evaluated to support shared decision making (SDM) and a patient‐centred approach. In this study, a PtDA template was developed to support two different preference sensitive decisions: adjuvant therapy for breast cancer and diagnostic workup for lung cancer. The aim of the study was to explore whether a PtDA improved SDM and supported a patient‐centred approach from an observational point of view. Methods Real‐life observations were conducted using the validated observational instrument OPTION 12. Three nurses conducted observations of consultations in two different clinical settings. The study consisted of a baseline cohort (phase 1) and an intervention cohort (phase 2). In phase 1, standard consultations were observed. Subsequently, the PtDA was introduced, and in phase 2, consultations with the clinician using the PtDA were observed. Results Twenty‐nine observations were conducted in phase 1 and 24 in phase 2. Using a PtDA increased the overall OPTION score significantly ( P < .0001), both in decisions on adjuvant treatment for breast cancer and on diagnostic workup of lung cancer. Items in the OPTION instrument regarding systematic conversation to obtain SDM had a higher increase of scores compared to items regarding a patient‐centred approach. Conclusion Real‐life observations and the use of a validated observational tool provided comprehensive knowledge as to how a PtDA affects SDM in consultations. Applying a PtDA resulted in a significant overall increase of SDM behaviour in decisions on adjuvant treatment after breast cancer surgery and diagnostic workup in case of a small suspicion of lung cancer. In conclusion, the PtDA supports SDM in consultations independently of type of decision and department.