Feasibility of Rapidly Developing and Widely Disseminating Patient Decision Aids to Respond to Urgent Decisional Needs due to the COVID-19 Pandemic

Stacey, Dawn; Ludwig, Claire; Archambault, Patrick; Babulic, Kevin; Edwards, Nancy; Lavoie, Josée G.; Sinha, Samir K.; O’Connor, Annette M.

doi:10.1177/0272989x20979693

Cited by 17 publications

(15 citation statements)

References 17 publications

(21 reference statements)

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“…First, COVID-19-related decision aids are already available. 48 Moreover, our findings suggest that individuals appear to be moderately accepting of triage scenarios, but many are clearly distressed by this scenario. Ultimately, it is apparent that SDM may be limited when resources are severely strained.…”

Section: Discussionmentioning

confidence: 66%

Shared Decision Making during the COVID-19 Pandemic

2021

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Objective The COVID-19 pandemic pushed some of the most well-developed health care systems to their limits. In many cases, this has challenged patient-centered care. We set out to examine individuals’ attitudes toward shared decision making (SDM) and to identify predictors of participation preference during the pandemic. Methods We conducted an online survey with a large convenience sample ( N = 1061). Our main measures of interest were participants’ generic and COVID-19–related participation preference as well as their acceptance and distress regarding a triage vignette. We also assessed anxiety, e-health literacy, and aspects of participants’ health. We conducted group comparisons and multiple linear regression analyses on participation preference as well as triage acceptance. Results In generic decision making, most participants expressed a strong need for information and a moderate participation preference. In the hypothetical case of COVID-19 infection, most preferred physician-led decisions. Generic participation preference was the strongest predictor of COVID-19–related participation preference, followed by age, education, and anxiety. Furthermore, both higher generic and COVID-19–related participation preferences predicted lower triage acceptance. Conclusion Our findings demonstrate potential health care recipients’ attitudes toward SDM during a severe health care crisis and emphasize that participation preference varies according to the context.

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Section: Discussionmentioning

confidence: 66%

Shared Decision Making during the COVID-19 Pandemic

2021

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“…3 , 4 During the pandemic, 2 decision aids designed to support families making decisions about moving their relative were downloaded more than 10,000 times in 3 wk, indicating the urgent need for effective decision support in this area. 69 As the COVID-19 experience may propel an increase in preference for aging at home rather than in nursing homes or private senior residences, decisions about safety at home will only increase in importance. 56 Caregivers should be kept up to date on new options to help older adults stay safe.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Decision Regret among Caregivers of Older Canadians Receiving Home Care: A Cross-Sectional Online Survey

Lognon

Gogovor

Plourde

et al. 2022

MDM Policy & Practice

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Background. In Canada, caregivers of older adults receiving home care face difficult decisions that may lead to decision regret. We assessed difficult decisions and decision regret among caregivers of older adults receiving home care services and factors associated with decision regret. Methods. From March 13 to 30, 2020, at the outbreak of the COVID-19 pandemic, we conducted an online survey with caregivers of older adults receiving home care in the 10 Canadian provinces. We distributed a self-administered questionnaire through Canada’s largest and most representative private online panel. We identified types of difficult health-related decisions faced in the past year and their frequency and evaluated decision regret using the Decision Regret Scale (DRS), scored from 0 to 100. We performed descriptive statistics as well as bivariable and multivariable linear regression to identify factors predicting decision regret. Results. Among 932 participants, the mean age was 42.2 y (SD = 15.6 y), and 58.4% were male. The most frequently reported difficult decisions were regarding housing and safety (75.1%). The mean DRS score was 28.8/100 (SD = 8.6). Factors associated with less decision regret included higher caregiver age, involvement of other family members in the decision-making process, wanting to receive information about the options, and considering organizations interested in the decision topic and health care professionals as trustworthy sources of information (all P < 0.001). Factors associated with more decision regret included mismatch between the caregiver’s preferred option and the decision made, the involvement of spouses in the decision-making process, higher decisional conflict, and higher burden of care (all P < 0.001). Discussion. Decisions about housing and safety were the difficult decisions most frequently encountered by caregivers of older adults in this survey. Our results will inform future decision support interventions. Highlights This is one of the first studies to assess decision regret among caregivers of older adults receiving home and community care services and to identify their most frequent difficult decisions. Difficult decisions were most frequently about housing and safety. Most caregivers of older adults in all 10 provinces of Canada experienced decision regret. Factors associated with less decision regret included higher caregiver age, the involvement of other family members in the decision-making process, wanting to receive information about the options, considering organizations interested in the decision topic, and health care professionals as trustworthy sources of information. Factors associated with more decision regret included mismatch between the caregiver’s preferred option and the decision made, the involvement of spouses in the decision-making process, higher decisional conflict, and higher burden of care.

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“…The integration of artificial intelligence into PDA may also be a promising mechanism to enhance the effectiveness of SDM [26,27]. Nevertheless, challenges of SDM might exist, such as patients with multiple disease conditions and limited health literacy and older patients who require specially designed SDM tools [28], those lacking socioeconomic resources and family support, and the rapidly emerging management options for specific medical problems that demand timely updates for SDM, as well as healthcare settings facing the COVID pandemic [29]. Indeed, a versatile and convenient platform both for the providers and patients might be necessary for the era of digital transformation in the healthcare practice.…”

Section: Discussionmentioning

confidence: 99%

Improving the Process of Shared Decision-Making by Integrating Online Structured Information and Self-Assessment Tools

Hsu

Kuo

et al. 2022

JPM

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The integration of face-to-face communication and online processes to provide access to information and self-assessment tools may improve shared decision-making (SDM) processes. We aimed to assess the effectiveness of implementing an online SDM process with topics and content developed through a participatory design approach. We analyzed the triggered and completed SDM cases with responses from participants at a medical center in Taiwan. Data were retrieved from the Research Electronic Data Capture (REDCap) database of the hospital for analysis. Each team developed web-based patient decision aids (PDA) with empirical evidence in a multi-digitized manner, allowing patients to scan QR codes on a leaflet using their mobile phones and then read the PDA content online. From July 2019 to December 2020, 48 web-based SDM topics were implemented in the 24 clinical departments of this hospital. The results showed that using the REDCap system improved SDM efficiency and quality. Implementing an online SDM process integrated with face-to-face communication enhanced the practice and effectiveness of SDM, possibly through the flexibility of accessing information, self-assessment, and feedback evaluation.

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Feasibility of Rapidly Developing and Widely Disseminating Patient Decision Aids to Respond to Urgent Decisional Needs due to the COVID-19 Pandemic

Cited by 17 publications

References 17 publications

Shared Decision Making during the COVID-19 Pandemic

Shared Decision Making during the COVID-19 Pandemic

Predictors of Decision Regret among Caregivers of Older Canadians Receiving Home Care: A Cross-Sectional Online Survey

Improving the Process of Shared Decision-Making by Integrating Online Structured Information and Self-Assessment Tools

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