Patient Decision Aid (PDA) for Patients with Rheumatoid Arthritis Reduces Decisional Conflict and Improves Readiness for Treatment Decision Making (original) (raw)

Decision aids for patients facing health treatment decisions in Spain: Preliminary results

Patient Education and Counseling, 2010

This study presents ongoing research aimed at understanding the suitability and impact of various decision aids (DAs) on patients with different chronic conditions in the Spanish National Health System.A three-phase process was employed to develop and evaluate DAs for patients with hip or knee osteoarthritis (OA), benign prostatic hyperplasia (BPH), and depression, including: (1) systematic reviews on the effectiveness of shared decision making (SDM) interventions (including DAs); (2) the development of DAs; (3) a pilot study assessing the DAs.Systematic reviews carried out highlight that there are few studies assessing the effectiveness of DAs for OA, BPH, and depression. The development of DAs and their assessment currently differs for each medical condition. The DAs assessed for OA and BHP are well accepted. In a pilot study with OA patients, the DA produced a significant improvement in the decisional conflict “informed” subscale.Research on SDM and DAs for different chronic conditions is at a very early stage in Spain. It is not possible to draw any definite conclusions about the effectiveness of DAs for clinical practice.It is necessary to conduct more high quality studies to evaluate the effects of DAs in the Spanish context.

Effects of a Web-Based Patient Decision Aid on Biologic and Small Molecule Agents for Rheumatoid Arthritis, ANSWER-2: A Proof-of-Concept Study

Arthritis care & research, 2017

To assess the extent to which ANSWER-2, an interactive online patient decision aid, reduces patients' decisional conflict and improves their medication-related knowledge and self-management capacity. We used a pre-post study design. Eligible participants had a diagnosis of rheumatoid arthritis (RA), had been recommended to start using a biologic or small molecule agent or to switch to a new one, and had Internet access. Access to ANSWER-2 was provided immediately after enrollment. Outcome measures included: 1) Decisional Conflict Scale (DCS), 2) Partners in Health Scale (PIHS), and 3) Medication Education Impact Questionnaire (MeiQ). Paired t-test was used to assess differences pre and post intervention. Of 50 participants, 40 were women with a mean age of 49.6 years (SD: 12.2). The median disease duration was 5 years (Quartile 1; Quartile 3: 2; 10). The mean DCS was 45.9 (SD: 25.1) pre-intervention and 25.1 (SD: 21.8) post-intervention (change: -21.2, 95% CI: -28.1, -14.4; p &l...

Decision tool to improve the quality of care in rheumatoid arthritis

2012

Objective Despite the importance of achieving tight control, many patients with rheumatoid arthritis (RA) are not effectively treated with disease-modifying antirheumatic drugs. The objective of this study was to develop a decision support tool to inform RA patients with ongoing active disease about the risks and benefits related to biologic therapy. Methods We developed a balanced, web-based, decision support tool. Options, values, and probabilistic information were described using theoretically supported formulations.