ObjectiveTo quantify the extent to which clinicians use clinically-efficacious decision aids as intended during implementation in practice and how fidelity to usage instructions correlates with shared decision making (SDM) outcomes.
Methods:
Participant-level meta-analysis including six practice-based randomized controlled trials of SDM in various clinical settings encompassing a range of decisions.
Results:
Of 339 encounters in the SDM intervention arm of the trials, 229 were video recorded and available for analysis. The mean proportion of fidelity items observed in each encounter was 58.4% (SD = 23.2).
The proportion of fidelity items observed was significantly associated with patient knowledge (p = 0.01) and clinician involvement of the patient in decision making (p
Conclusion:
Clinicians’fidelity to usage instructions of point-of-care decision aids in randomized trials was suboptimal during their initial implementation in practice, which may have underestimated the potential efficacy of decision aids when used as intended.
Author: Kirk D WyattMegan E BrandaRyan T AndersonLaurie J PencilleVictor M MontoriErik P HessHenry H TingAnnie LeBlanc
Credits/Source: Implementation Science 2014, 9:26
Published on: 2014-02-22
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News Provider: EUPB – European Press Bureau
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