Medical versus surgical methods of early abortion: protocol for a systematic review and environmental scan of patient decision aids

Donnelly, Kyla Z; Thompson, Rachel

doi:10.1136/bmjopen-2015-007966

Cited by 26 publications

(42 citation statements)

References 57 publications

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“…A strength of this study lies in the novelty of an environmental scan to allow us to describe the real‐time landscape of patient education deprescribing materials as a traditional systematic review of the academic literature would have been an ineffective approach in this context . An environmental scan can be used to supplement systematic reviews that focus solely on peer‐reviewed literature .…”

Section: Discussionmentioning

confidence: 99%

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Availability and readability of patient education materials for deprescribing: An environmental scan

Fajardo

Weir

Bonner

et al. 2019

Brit J Clinical Pharma

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Aims To identify and evaluate content and readability of freely available online deprescribing patient education materials (PEMs). Methods Systematic review of PEMs using MEDLINE, Embase, CINAHL, PsycINFO and The Cochrane Library of Systematic Reviews from inception to 25 September 2017 to identify PEMs. Additionally, deprescribing researchers and health professionals were surveyed to identify additional materials. Known repositories of materials were searched followed by a systematic Google search (22–28 January 2018). Materials were evaluated using an approach informed by the Patient Education Material Assessment Tool and the International Patient Decision Aids Standards Inventory. Readability of text‐based materials was assessed using the US‐based Gunning–Fog Index and Flesch–Kincaid Grade level. Results Forty‐eight PEMs were identified. PEMs addressing deprescribing of medications for symptom control (81%) were most common. Preventative medications were rarely addressed and material (39%) focused on older people. Only 37% of PEMs provided information about both potential benefits (e.g. reducing risk of side effects) and harms (e.g. withdrawal symptoms, increased risk of disease) of deprescribing, while 40% focussed on benefits only. Readability indices indicated an average minimum reading level of Grade 12. Option Grids and Decision Aids (mean reading level below Grade 10) were most suitable for people with average literacy levels. Conclusions Over 1/3 of deprescribing PEMs present potential benefits and harms of deprescribing indicating most of the freely available materials are not balanced. Most PEMs are pitched above average reading levels making them inaccessible for low health literacy populations.

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Section: Discussionmentioning

confidence: 99%

“…We adapted the methodology of this environmental scan from previous research in the patient communication field . This methodology starts with a traditional systematic review and is complemented with systematic Internet searches and questionnaires to identify materials that would not appear in a traditional systematic review.…”

Section: Methodsmentioning

confidence: 99%

Availability and readability of patient education materials for deprescribing: An environmental scan

Fajardo

Weir

Bonner

et al. 2019

Brit J Clinical Pharma

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“…After finalization of the study protocol, we elected also to exclude studies of women whose gestational age was unclear and studies evaluating decision coaching not accompanied by a physical tool …”

Section: Methodsmentioning

confidence: 99%

“…The screening and full review process of Internet pages and apps is described in full in the protocol . We had planned to screen both titles and abstracts of all articles after duplicate entries were removed, but ultimately opted to screen only titles unless further clarification from the abstract was needed.…”

Section: Methodsmentioning

confidence: 99%

“…As we have described previously, women in the United States value receiving quality information and support when making decisions about early abortion . The two recommended methods, surgical and medical abortion, are both highly effective, safe and acceptable, yet differ across several aspects (eg duration, bleeding and cramping profile, where the abortion takes place, follow‐up visit requirements) .…”

Section: Introductionmentioning

confidence: 99%

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Quantity over quality—Findings from a systematic review and environmental scan of patient decision aids on early abortion methods

Donnelly

Elwyn

Thompson

2017

Health Expectations

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BackgroundThe availability and effectiveness of decision aids (DAs) on early abortion methods remain unknown, despite their potential for supporting women's decision making.ObjectiveTo describe the availability, impact and quality of DAs on surgical and medical early abortion methods for women seeking induced abortion.Search strategyFor the systematic review, we searched MEDLINE, Cochrane Library, CINAHL, EMBASE and PsycINFO. For the environmental scan, we searched Google and App Stores and consulted key informants.Inclusion criteriaFor the systematic review, we included studies evaluating an early abortion method DA (any format and language) vs a comparison group on women's decision making. DAs must have met the Stacey et al (2014). Cochrane review definition of DAs. For the environmental scan, we included English DAs developed for the US context.Data extraction and synthesisWe extracted study and DA characteristics, assessed study quality using the Effective Practice and Organization of Care risk of bias tool and assessed DA quality using International Patient Decision Aid Standards (IPDAS).ResultsThe systematic review identified one study, which found that the DA group had higher knowledge and felt more informed. The evaluated DA met few IPDAS criteria. In contrast, the environmental scan identified 49 DAs created by non‐specialists. On average, these met 28% of IPDAS criteria for Content, 22% for Development and 0% for Effectiveness.ConclusionsResearch evaluating DAs on early abortion methods is lacking, and although many tools are accessible, they demonstrate suboptimal quality. Efforts to revise existing or develop new DAs, support patients to identify high‐quality DAs and facilitate non‐specialist developers' adoption of best practices for DA development are needed.

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Quality and effectiveness of osteoporosis treatment decision aids: a systematic review and environmental scan

et al. 2020

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Decision aids (DA) are evidence-based tools that support shared decision-making (SDM) implementation in practice; this study aimed to identify existing osteoporosis DAs and assess their quality and efficacy; and to gain feedback from a patient advisory group on findings and implications for further research. MethodsWe searched multiple bibliographic databases to identify research studies from 2000 to 2019 and undertook an environmental scan (search conducted February 2019, repeated in March 2020). A pair of reviewers, working independently selected studies for inclusion, extracted data, evaluated each trial's risk of bias, and conducted DA quality assessment using the International Patient Decision Aid Standards (IPDAS). Public contributors (patients and caregivers with experience of osteoporosis and fragility fractures) participated in discussion groups to review a sample of DAs, express preferences for a new DA and discuss plans for development of a new DA. ResultsWe identified 6 studies, with high or unclear risk of bias. Across included studies, use of an osteoporosis DA was reported to result in reduced decisional conflict compared with baseline, increased SDM and increased accuracy of patients' perceived fracture risk compared with controls.Eleven DAs were identified, of which none met the full set of IPDAS criteria for certification for minimization of bias. Public contributors expressed preferences for encounter DAs that are individualized to patients' own needs and risk. ConclusionsExisting DAs for informing patient decisions about osteoporosis treatment fail to comprehensively meet international quality standards and patient needs, underpinning the need for new DA development.

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Medical versus surgical methods of early abortion: protocol for a systematic review and environmental scan of patient decision aids

Cited by 26 publications

References 57 publications

Availability and readability of patient education materials for deprescribing: An environmental scan

Availability and readability of patient education materials for deprescribing: An environmental scan

Quantity over quality—Findings from a systematic review and environmental scan of patient decision aids on early abortion methods

Quality and effectiveness of osteoporosis treatment decision aids: a systematic review and environmental scan

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