Dissemination of Patient Decision-Making Aids via a Web-based Platform

Purposes/Aims: The Patient Protection and Affordable Care Act includes a provision promoting shared decision making and the use of patient decision support interventions, but this has yet to be implemented in the United States. Clinicians cite a wide variety of financial, cultural, scientific and pragmatic barriers to utilizing shared patient decision support interventions in their daily practice. Decision-making aids are evidence-based tools that complement clinician counseling by listing available treatment options, information about generalized risks/benefits/outcomes, and clarifying the patient’s personal values. The aim of this study is to create and evaluate a web-based brokerage of patient decision-making aids to increase patient participation in care planning and support the shared decision-making efforts of clinicians.

Rationale/Background: Adult patients in primary care settings frequently report confusion and a lack of knowledge about medical treatment options, hindering their ability to fully participate in healthcare decision-making. Clinicians report frustration when discussing treatment options with patients who have already received information from unreliable internet sources, such as Wikipedia and weblogs. Over 500 evidence-based decision aids are currently available on the internet, but are scattered across dozens of websites and not well advertised to the general public. Creation of a web-based decision-aid platform would utilize the existing information-seeking habits of patients, but provide them with evidence-based information to aid them in evaluating treatment options with their healthcare providers. Currently, no such platform exists in the United States for patients to freely access.

Methods: Using a descriptive dissemination design, and informed by the Institute of Healthcare Improvement and Plan-Do-Study-Act models of quality improvement, the effect of a pilot decision-aid brokerage website on satisfaction and shared decision making will be measured. Exemplars will be chosen from the 563 decision aids published by numerous organizational and private authors in the Ottawa Research Institute database. Data Collection: Before and after accessing each decision aid, participants will be asked questions about treatment concepts to highlight areas they may want to further discuss with their clinician on their next office visit. Demographic information will be collected from each website user. Open-ended questions about website usefulness will be asked. Data Analysis: Descriptive statistics analyzed to describe the population utilizing the platform. Qualitative content analysis will explore participants’ perceptions of usefulness of the website to support shared decision-making.  

Conclusions/Implications for Practice: Having access to high-quality, evidence-based educational materials is vital to improving health outcomes. This study supports shared decision making between provider and patient by increasing access to readily available decision aids and educational materials. A web-based platform is in development to disseminate decision aids broadly, including to those areas traditionally underserved.