Development and test of a decision aid for shared decision making in
patients with anterior cruciate ligament injury
Abstract
Rationale, aims and objectives Patients with anterior crucial ligament
injury are faced with a choice between surgery or non-surgical treatment
with intensive rehabilitation. Evidence shows that surgical treatment is
not superior to non-surgical treatment. To offer patients a treatment
meeting their individual values, lifestyle and conditions, patients must
be involved in the decision-making. The aim of the study was to develop
and evaluate a patient decision aid to support shared decision-making.
Method Development of the patient decision aid was based on
international criteria, current literature, and former patients’
experiences and suggestions on how to optimize the decision-making
process. The patient decision aid was evaluated by the SDM-Q9
questionnaire and semi-structured interviews with patients and doctors.
Results A patient decision aid for patients with and an anterior crucial
ligament injury was developed. On a scale from 0-5, patients experienced
a high degree of shared decision-making in their treatment decision both
before (score 4.3) and after (score 4.3) implementation of the patient
decision aid. No statically significant difference was found (p=0.72).
From interviews, patients expressed that they found the patient decision
aid very useful. Especially, reflection time was important for some
patients. Doctors reported that the patient decision aid improved shared
decision-making by supporting the dialogue clarifying patients’ values
concerning issues important for treatment choices. Conclusion No
statically significant difference in the SDM Q9 -score was found between
patients’ perceptions of shared decision-making before and after
implementation of a patient decision aid. However, patients experienced
the decision aid as very useful when making treatment decisions, and
doctors reported that it improved the dialogue clarifying patients’
values important for the treatment options. Keywords patient-centered
care, evaluation, person-centered medicine