Peering into the black box: a meta-analysis of how clinicians use decision aids during clinical encounters.
Implement Sci
; 9: 26, 2014 Feb 22.
Article
en En
| MEDLINE
| ID: mdl-24559190
ABSTRACT
OBJECTIVE:
To 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 <0.0001), while no association was found with patient decisional conflict or satisfaction with the encounter.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.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
2_ODS3
Problema de salud:
2_enfermedades_transmissibles
Asunto principal:
Participación del Paciente
/
Personal de Salud
/
Sistemas de Apoyo a Decisiones Clínicas
Tipo de estudio:
Clinical_trials
/
Prognostic_studies
/
Systematic_reviews
Aspecto:
Patient_preference
Límite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Implement Sci
Año:
2014
Tipo del documento:
Article