Patient-Centered Care, Shared Decision Making and Patient Decision Aids

Today we had a great talk by our very own Dr. Emily Bowen, PGY2. She talked about Patient Decision Aids.

Wanting LESS of this:
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And MORE of this:

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Some points from her talk today!

UTSWIM: What are patient decision aids?
Dr. Bowen: As the focus on shared decision making began to increase after the IOM report, the number of patient decision aids available was rapidly expanding. . It was hard to know which ones were based on accurate information and which were actually effective. This led to the foundation of IPDAS in 2003.
UTSWIM: and what did the IPDAS do?
Dr. Bowen: It provided Qualifying Criteria to be a patient decision aid: 1.Identify a specific decision to be made, 2.Helps patients choose deliberately among options, 3.Positive and negative features of the options are presented, 4.Outcomes provided are relevant to health status, 5.Does not recommend one option over others, 6.Helps patients clarify their values.
UTSWIM: so what does the literature show?
Dr. Bowen: A 2014 cochrane review of 115 randomized trials involving >34,000 patients showed that decision aids increase knowledge, increase risk perception by patients, higher proportion of patients choosing an option congruent with their values, lowered decisional conflict but the effects of decision aids on adherence, cost, and resource use were inconclusive
UTSWIM: can you share some examples of decision aids that you liked?
Dr. Bowen:  Of course! Below are some examples that we also put onto our Residency website.
Statins
https://statindecisionaid.mayoclinic.org/

Diabetes: 
https://diabetesdecisionaid.mayoclinic.org/

AHRQ’s decision aids:
http://effectivehealthcare.ahrq.gov/index.cfm/tools-and-resources/patient-decision-aids/ Please note, I have NOT reviewed the evidence for each of these individually so cannot advocate for their efficacy or the evidence behind them specifically.
Prostate Cancer:

http://onlinelibrary.wiley.com/store/10.1002/cncr.30367/asset/supinfo/cncr30367-sup-0003-suppinfo.pdf?v=1&s=6b8485e1b7989a7b99397e3f9a56e051fb64779b (This is the prostate cancer screening decision aid currently available from ACS: slightly different than the one I will show in the talk but similar)
http://www.cancer.org/acs/groups/content/@editorial/documents/document/acspc-024618.pdf

Thank you so much taking time Dr. Emily Bowen for your Resident Update Talk!
UTSWIM