Assignment: Explored Provider Perspectives

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Assignment: Explored Provider Perspectives

Assignment: Explored Provider Perspectives

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Discussion

Decision aids are evidence-based tools that

enable patients to make informed, value-con-

cordant choices, but the extent to which such

tools facilitate SDM from the perspective of the

provider is less well established. In an effort to

gain new insight into the issue, we conducted a

survey of primary care providers participating in

a clinical trial evaluating the impact of a novel,

DVD-formatted decision aid on SDM and

adherence to CRC screening. Our study finds

that a majority of providers perceived that the

tool was a useful, time-saving adjunct to their

usual approach to counselling about CRC

screening and increased the overall quality of

decision making. Moreover, providers also felt

that review of the tool just prior to a scheduled

office visit was an appropriate use of patient�s time as it enabled the patient to make an

informed choice among the different screening

options. Together, these findings suggest that

much of the tool�s perceived utility was related to its ability to better prepare patients for the

screening discussion outside of the clinical

encounter and, in so doing, increased both the

efficiency and quality of the interaction.

Few studies have explored provider perspec-

tives on the utility of decision aids for improving

SDM. A trial by Green et al. evaluating the

effectiveness of genetic counselling vs. counsel-

ling preceded by use of a computer-based deci-

sion aid for breast cancer susceptibility found

that although there were no significant differ-

ences in perceived effectiveness, use of the tool

saved time and shifted the focus away from basic

education towards a discussion of personal risk

and decision making.17 A second study by Sim-

inoff et al. found that a decision aid for breast

cancer adjuvant therapy facilitated a more

interactive, informed discussion and helped

physicians understand patient preferences.13

Similarly, Brackett et al. also found that pre-

visit use of decision aids for prostate and CRC

screening was associated with greater physician

satisfaction, as it saved time during the visit and

changed the conversation from one of the

informational exchanges to one of the values

and preferences.18 A fourth study by Graham

et al. explored provider perceptions of three

decision aids prior to their actual use.15

 

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