Physicians' Awareness and Attitudes Toward Decision Aids for Patients With Cancer

Brace, Chantalle; Schmocker, Selina; Huang, Harden; Victor, J. Charles; McLeod, Robin S.; Kennedy, Erin

doi:10.1200/jco.2009.25.2874

Cited by 43 publications

(35 citation statements)

References 38 publications

(12 reference statements)

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“…The belief that PtDA is a relevant source of information for both clinicians and the patients is also supported in other studies [30, 31]. Finally, a lack of knowledge/awareness of PtDAs among health professionals, our sixth most influential factor, is supported by Brace et al [32]. Any implementation strategy for use of PtDAs about DS screening in the clinic needs to specifically consider these six most important factors, a finding consistent with results of previous studies.…”

Section: Discussionmentioning

confidence: 57%

“…A highly positive appraisal of three PtDAs was reported by Graham et al in 2007 and to a lesser extent in 2003 [30, 31]. The easy availability of PtDAs as a facilitator has not been clearly reported elsewhere, but their lack of availability has been noted as a disadvantage or barrier, which amounts to the same thing [30, 32]. Graham et al also identified colleagues’ approval as an important influential factor [30, 31].…”

Section: Discussionmentioning

confidence: 99%

“…PtDAs about DS screening, as well as the Quebec government pamphlet [29], were almost unknown to our participants, especially for family physicians and obstetricians-gynecologists. A study in the context of cancer treatment found a similar proportion of respondents who said the main barrier to their using PtDAs was lack of awareness of their existence [32]. This issue could be addressed by opinion leaders endorsing their use [36].…”

Section: Discussionmentioning

confidence: 99%

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What factors influence health professionals to use decision aids for Down syndrome prenatal screening?

Lépine¹,

Portocarrero²,

Delanoë³

et al. 2016

BMC Pregnancy Childbirth

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BackgroundHealth professionals are expected to engage pregnant women in shared decision making to help them make informed values-based decisions about prenatal screening. Patient decision aids (PtDAs) foster shared decision-making, but are rarely used in this context. Our objective was to identify factors that could influence health professionals to use a PtDA for decisions about prenatal screening for Down syndrome during a clinical pregnancy follow-up.MethodsWe planned to recruit a purposive sample of 45 health professionals (obstetrician-gynecologists, family physicians and midwives) involved in the care of pregnant women in three clinical sites (15 per site). Participating health professionals first watched a video showing two simulated consecutive prenatal follow-up consultations during which a pregnant woman, her partner and a health professional used a PtDA about Down syndrome prenatal screening. Participants were then interviewed about factors that would influence their use of the PtDA. Questions were based on the Theoretical Domains Framework. We performed content analyses of transcribed verbatim interviews.ResultsOut of 42 eligible health professionals approached, 36 agreed to be interviewed (86 % response rate). Of these, 27 were female (75 %), nine were obstetrician-gynecologists (25 %), 15 were family physicians (42 %), and 12 were midwives (33 %), with a mean age of 42.1 ± 11.6 years old. We identified 35 distinct factors reported by 20 % or more participants that were mapped onto 10 of the 12 of the Theoretical Domains Framework domains. The six most frequently mentioned factors influencing use of the PtDA were: 1) a positive appraisal (n = 29, 81 %, beliefs about consequences domain); 2) its availability in the office (n = 27, 75 %, environmental context and resources domain); 3) colleagues’ approval (n = 27, 75 %, social influences domain); 4) time constraints (n = 26, 72 %, environmental context and resources domain); 5) finding it a relevant source of information (n = 24, 67 %, motivation and goals domain); and 6) not knowing any PtDAs (n = 23, 64 %, knowledge domain).ConclusionsAppraisal, PtDA availability, peer approval, time concerns, evidence and PtDA awareness all affect whether health professionals are likely to use a PtDA to help pregnant women make informed decision about Down syndrome screening. Implementation strategies will need to address these factors.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-016-1053-2) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

What factors influence health professionals to use decision aids for Down syndrome prenatal screening?

Lépine¹,

Portocarrero²,

Delanoë³

et al. 2016

BMC Pregnancy Childbirth

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“…Among various barriers elicited for their use, physicians mentioned the lack of time and resources. 21 There is a need for an efficient and simple-to-use decision aid that could be integrated in the medical visit without disrupting the consultation.…”

Section: Implications For Practicementioning

confidence: 99%

Impact of a printed decision aid on patients’ intention to undergo prostate cancer screening: a multicentre, pragmatic randomised controlled trial in primary care

et al. 2015

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BackgroundDespite recommendations against systematic screening for prostate cancer, 70% of patients still request prostate-specific antigen testing. AimTo assess the impact of a decision aid on patients' intention to undergo prostate cancer screening. Design and settingRandomised controlled trial with two-arm parallel groups in 86 general practices in urban and rural areas in France. MethodMales aged 50-75 years were randomised to receive either the decision aid (intervention group) or usual care (control group). The primary outcome was the proportion of patients' intending to undergo prostate cancer screening, assessed immediately after reading the decision aid. The reasons underlying their choice were elicited and the proportion of patients citing each reason to undergo, or not undergo, prostate cancer screening were compared between the two arms. ResultsA total of 1170 patients were randomised (588 in the intervention arm) from November 2012 to February 2013. The proportion of patients who intended to be tested for prostate cancer in the intervention arm (123 patients [20.9%]) was significantly reduced compared with the control arm (57 patients [9.8%]) (difference 11.1%, 95% confidence interval [CI] = 7.0 to 15.2, P<0.0001). In the intervention group, a lower proportion of individuals expressed that cancer screening would protect them from the disease, compared with the control group (P<0.0001), while a greater proportion of individuals stated that prostate cancer screening would not benefit their health (P<0.0001) and may involve procedures with harmful side effects (P = 0.0005). ConclusionThe decision aid improved participants' informed decision making and reduced their intent to undergo prostate cancer screening.Keywords decision making; early detection of cancer; primary care; prostatic neoplasm; randomised controlled trial.

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“…The main barriers to the use of decision aids in practice appear to be a lack of awareness and limited time and resources. 40 Decision-support interventions. In contrast to decision aids, decision-support interventions help people think about the choices they face, describe where and why choice exists, and provide information about options including, where reasonable, the option of taking no action.…”

Section: Patient and Family Engagementmentioning

confidence: 99%

Optimizing Population Health and Economic Outcomes: Innovative Treatment for BPH

Janice¹

2013

Population Health Management

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Physicians' Awareness and Attitudes Toward Decision Aids for Patients With Cancer

Cited by 43 publications

References 38 publications

What factors influence health professionals to use decision aids for Down syndrome prenatal screening?

What factors influence health professionals to use decision aids for Down syndrome prenatal screening?

Impact of a printed decision aid on patients’ intention to undergo prostate cancer screening: a multicentre, pragmatic randomised controlled trial in primary care

Optimizing Population Health and Economic Outcomes: Innovative Treatment for BPH

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