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. 2011 Dec 21;1(2):e000261.
doi: 10.1136/bmjopen-2011-000261. Print 2011.

Helping pregnant women make better decisions: a systematic review of the benefits of patient decision aids in obstetrics

Rebecca Say  1 , Stephen Robson, Richard Thomson
Affiliations

Helping pregnant women make better decisions: a systematic review of the benefits of patient decision aids in obstetrics

Rebecca Say et al. BMJ Open. .

Abstract

Objectives Patient decision aids can be used to support pregnant women engaging in shared decisions, but little is known about their effects in obstetrics. The authors aimed to evaluate the effects of patient decision aids designed for pregnant women on clinical and psychosocial outcomes. Design Systematic review. Data on all outcomes were extracted and summarised. All studies were critically appraised for potential sources of bias and, when possible to obtain, the reported decision aids were evaluated. Meta-analysis was not possible due to the heterogeneity of outcomes in primary studies and the small number of studies. Data sources Electronic searches were performed using Medline, Embase, the Cochrane Library and Medion databases from inception until December 2010. Reference lists of all included articles were also examined and key experts contacted. Eligibility criteria for selecting studies Eligibility criteria included randomised controlled trials, which reported on patient decision aids for women facing any treatment decision in pregnancy published in English. Studies evaluating health education material that did not address women's values and preferences were excluded. Results Patient decision aids have been developed for decisions about prenatal testing, vaginal birth after Caesarean section, external cephalic version and labour analgesia. Use of decision aids is associated with a number of positive effects including reduced anxiety, lower decisional conflict, improved knowledge, improved satisfaction and increased perception of having made an informed choice. Conclusions Patient decision aids have the potential to improve obstetric care. However, currently the evidence base is limited by the small number of studies, the quality of the studies and because they involved heterogeneous decision aids, patient groups and outcomes.

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Conflict of interest statement

Competing interests: None.

Figures

Figure 1
Figure 1
PRISMA 2009 flow diagram, from Moher et al. Visit http://www.prisma-statement.org for more information.
See this image and copyright information in PMC

References

    1. Holm S, Davies M. Ethical issues around evidence-based patient choice and shared decision making. In: Edwards A, Elwyn G, eds. Shared Decision-Making in Health Care. Oxford: Oxford University Press, 2009
    1. Say R, Thomson R. The importance of patient preferences in treatment decisions—challenges for doctors. BMJ 2003;327:542–5 - PMC - PubMed
    1. Sepucha K, Ozanne E, Silvia K, et al. An approach to measuring the quality of breast cancer decisions. Patient Educ Couns 2007;65:261–9 - PubMed
    1. Edwards A, Elwyn G. Shared decision-making in health care: achieving evidence-based patient choice. In: Edwards A, Elwyn G, eds. Shared Decision-Making in Health Care. Oxford: Oxford University Press, 2009
    1. Department of Health The Expert Patient: A New Approach to Chronic Disease Management for the 21st Century. London: Department of Health, 2001