Implementation and Effectiveness of Decision Aids in Patient Compliance

by Amyn Amlani, PhD

Last month, the reader was provided an overview of the application of decision aids in health care. Recall that decisions aids, such as educational booklets, DVDs, and Web-based interactive tools, provide patients with information to guide treatment decisions regarding their health care needs, values, and preferences.

In this month’s blog, we look at the implementation and effectiveness of decision aids in patient compliance to treatment recommendations.

 

Implementing Decision Aids into Clinical Practice

 

Prior to implementing a decision aid into clinical practice, each aspect of that practice (i.e., providers, assistants, front office staff, business staff) must be invested in the patient-centered model. In addition, the integration of decision aids into daily practice will require an overview of, and possible adjustment to, the patient workflow to ensure a clinical team effort towards shared decision-making.

Below are considerations towards creating a conducive environment when adopting decision aids:

1. Designate a multidisciplinary team to select, approve, and implement decision tools;
2. Clearly communicate the goals, expectations, and incentives for utilization of the decision aid;
3. Assess and standardize the patient and clinical workflow defined by the selection of the decision aid;
4. Provide training to all members of the practice on the use of the decision tool;
5. Make tools easily accessible to patients, with results available to them for review with family members;
6. Incorporate the patient responses into electronic medical records;
7. Include ongoing assessment and training—based on patient, provider, and staff feedback—to improve processes, integration, sand outcomes; and
8. Share outcome results with providers and staff on how decision aids have improved patient adherence to treatment and improved quality of care.

 

What is the Effectiveness of Decision Aids?

 

A 2014 Cochrane review of 115 randomized trials uncovered that decision aids provided patients with enhanced information allowing them to be better advised of their healthcare status and make better choices regarding potential interventions compared to patients who received usual care (i.e., provider counseling).¹ The enhanced information yielded:

• an increase in patient knowledge and understanding of the harms and benefits of various treatment interventions,
• increased and accurate perceptions of risks,
• greater comfort with their treatment decision, and
• a reduction in patient’s delaying treatment.

This same report also revealed that patients provided with decision aids made different choices than their uninformed peers. The report further notes that having enhanced information increased patient engagement with their provider, but the provider was not necessarily as open to the shared decision-making process.

 

Decision Aid Workflow and Tools in Hearing Care

 

For readers interested in learning more about decision aid workflow models and tools, the following sources are recommended:

1. Decision Aid: Options in the Hearing Clinic (Cox, 2013)
2. Weinstein BE, Gilligan J. (2013, December). Patient decision aids: Innovative tools for counseling in hearing health care settings. Audiology Practices. [Downloadable here]
3. Laplante-Lévesque, A., et al (2010). A qualitative study of shared decision making in rehabilitative Audiology. Journal of the Academy of Rehabilitative Audiology, 48, 27-43. [Downloadable here]
4. Pryce H, et al. (2017). The development of a decision aid for tinnitus. International Journal of Audiology, 57(9), 714-719. [Downloadable here]

 

Next Month…

We get into the economics of how decision aids reduce barriers and increase treatment compliance, and what that means to your practice with the changes happening in the hearing care space.