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. 2018 Feb;21(1):64-74.
doi: 10.1111/hex.12586. Epub 2017 Jun 21.

Views of general practice staff about the use of a patient-oriented treatment decision aid in shared decision making for patients with type 2 diabetes: A mixed-methods study

Anita Wildeboer  1 , Esther du Pon  2 , Jan Schuling  3 , Flora M Haaijer-Ruskamp  1 , Petra Denig  1
Affiliations

Views of general practice staff about the use of a patient-oriented treatment decision aid in shared decision making for patients with type 2 diabetes: A mixed-methods study

Anita Wildeboer et al. Health Expect. 2018 Feb.

Abstract

Background: Decision aids can be used to support shared decision making (SDM). A patient-oriented treatment decision aid (DA) was developed for type 2 diabetes but its use by general practice staff appeared to be limited.

Objectives: To explore views of practice staff towards SDM and the DA.

Design: A mixed-methods study within the Dutch PORTDA-diab trial.

Setting and participants: Included were 17 practices with staff members who were responsible for routine diabetes care and had worked with the DA, and 209 of their patients.

Methods: Interviews were conducted focusing on applicability, usefulness and feasibility of the DA. Interviews were tape-recorded, transcribed verbatim and subjected to content analysis for identifying and classifying views. Patient-reported data about the use of the DA were collected. Associations between specific views and use of the DA were tested using Pearson point-biserial correlation.

Results: The majority of practice staff expressed positive views towards SDM, which was associated with making more use of the DA. Most of the staff expressed that the DA stimulated a two-way conversation. By using the DA, several became aware of their paternalistic approach. Some staff experienced a conflict with the content of the DA, which was associated with making less use of the DA.

Conclusions: The DA was considered useful by practice staff to support SDM. A positive view towards SDM was a facilitator, whereas experiencing a conflict with the content of the DA was a barrier for making use of the DA.

Keywords: decision aids; diabetes mellitus type 2; patient-centered care; primary health care; qualitative research; shared decision making.

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Figures

Figure 1
Figure 1
Flow diagram of study participants
Figure 2
Figure 2
Example showing part of the decision aid
See this image and copyright information in PMC

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