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Designing and evaluating an interprofessional shared decision-making and goal-setting decision aid for patients with diabetes in clinical care--systematic decision aid development and study protocol.
Implement Sci. 2014 Jan 22; 9:16.IS

Abstract

BACKGROUND

Care of patients with diabetes often occurs in the context of other chronic illness. Competing disease priorities and competing patient-physician priorities present challenges in the provision of care for the complex patient. Guideline implementation interventions to date do not acknowledge these intricacies of clinical practice. As a result, patients and providers are left overwhelmed and paralyzed by the sheer volume of recommendations and tasks. An individualized approach to the patient with diabetes and multiple comorbid conditions using shared decision-making (SDM) and goal setting has been advocated as a patient-centred approach that may facilitate prioritization of treatment options. Furthermore, incorporating interprofessional integration into practice may overcome barriers to implementation. However, these strategies have not been taken up extensively in clinical practice.

OBJECTIVES

To systematically develop and test an interprofessional SDM and goal-setting toolkit for patients with diabetes and other chronic diseases, following the Knowledge to Action framework.

METHODS

1. Feasibility study: Individual interviews with primary care physicians, nurses, dietitians, pharmacists, and patients with diabetes will be conducted, exploring their experiences with shared decision-making and priority-setting, including facilitators and barriers, the relevance of a decision aid and toolkit for priority-setting, and how best to integrate it into practice.2. Toolkit development: Based on this data, an evidence-based multi-component SDM toolkit will be developed. The toolkit will be reviewed by content experts (primary care, endocrinology, geriatricians, nurses, dietitians, pharmacists, patients) for accuracy and comprehensiveness.3. Heuristic evaluation: A human factors engineer will review the toolkit and identify, list and categorize usability issues by severity.4. Usability testing: This will be done using cognitive task analysis.5. Iterative refinement: Throughout the development process, the toolkit will be refined through several iterative cycles of feedback and redesign.

DISCUSSION

Interprofessional shared decision-making regarding priority-setting with the use of a decision aid toolkit may help prioritize care of individuals with multiple comorbid conditions. Adhering to principles of user-centered design, we will develop and refine a toolkit to assess the feasibility of this approach.

Authors+Show Affiliations

Keenan Research Centre, Li Ka Shing Knowledge Institute of St, Michael's Hospital, Toronto, Canada. yuca@smh.ca.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24450385

Citation

Yu, Catherine H., et al. "Designing and Evaluating an Interprofessional Shared Decision-making and Goal-setting Decision Aid for Patients With Diabetes in Clinical Care--systematic Decision Aid Development and Study Protocol." Implementation Science : IS, vol. 9, 2014, p. 16.
Yu CH, Stacey D, Sale J, et al. Designing and evaluating an interprofessional shared decision-making and goal-setting decision aid for patients with diabetes in clinical care--systematic decision aid development and study protocol. Implement Sci. 2014;9:16.
Yu, C. H., Stacey, D., Sale, J., Hall, S., Kaplan, D. M., Ivers, N., Rezmovitz, J., Leung, F. H., Shah, B. R., & Straus, S. E. (2014). Designing and evaluating an interprofessional shared decision-making and goal-setting decision aid for patients with diabetes in clinical care--systematic decision aid development and study protocol. Implementation Science : IS, 9, 16. https://doi.org/10.1186/1748-5908-9-16
Yu CH, et al. Designing and Evaluating an Interprofessional Shared Decision-making and Goal-setting Decision Aid for Patients With Diabetes in Clinical Care--systematic Decision Aid Development and Study Protocol. Implement Sci. 2014 Jan 22;9:16. PubMed PMID: 24450385.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Designing and evaluating an interprofessional shared decision-making and goal-setting decision aid for patients with diabetes in clinical care--systematic decision aid development and study protocol. AU - Yu,Catherine H, AU - Stacey,Dawn, AU - Sale,Joanna, AU - Hall,Susan, AU - Kaplan,David M, AU - Ivers,Noah, AU - Rezmovitz,Jeremy, AU - Leung,Fok-Han, AU - Shah,Baiju R, AU - Straus,Sharon E, Y1 - 2014/01/22/ PY - 2013/11/19/received PY - 2014/01/15/accepted PY - 2014/1/24/entrez PY - 2014/1/24/pubmed PY - 2014/9/30/medline SP - 16 EP - 16 JF - Implementation science : IS JO - Implement Sci VL - 9 N2 - BACKGROUND: Care of patients with diabetes often occurs in the context of other chronic illness. Competing disease priorities and competing patient-physician priorities present challenges in the provision of care for the complex patient. Guideline implementation interventions to date do not acknowledge these intricacies of clinical practice. As a result, patients and providers are left overwhelmed and paralyzed by the sheer volume of recommendations and tasks. An individualized approach to the patient with diabetes and multiple comorbid conditions using shared decision-making (SDM) and goal setting has been advocated as a patient-centred approach that may facilitate prioritization of treatment options. Furthermore, incorporating interprofessional integration into practice may overcome barriers to implementation. However, these strategies have not been taken up extensively in clinical practice. OBJECTIVES: To systematically develop and test an interprofessional SDM and goal-setting toolkit for patients with diabetes and other chronic diseases, following the Knowledge to Action framework. METHODS: 1. Feasibility study: Individual interviews with primary care physicians, nurses, dietitians, pharmacists, and patients with diabetes will be conducted, exploring their experiences with shared decision-making and priority-setting, including facilitators and barriers, the relevance of a decision aid and toolkit for priority-setting, and how best to integrate it into practice.2. Toolkit development: Based on this data, an evidence-based multi-component SDM toolkit will be developed. The toolkit will be reviewed by content experts (primary care, endocrinology, geriatricians, nurses, dietitians, pharmacists, patients) for accuracy and comprehensiveness.3. Heuristic evaluation: A human factors engineer will review the toolkit and identify, list and categorize usability issues by severity.4. Usability testing: This will be done using cognitive task analysis.5. Iterative refinement: Throughout the development process, the toolkit will be refined through several iterative cycles of feedback and redesign. DISCUSSION: Interprofessional shared decision-making regarding priority-setting with the use of a decision aid toolkit may help prioritize care of individuals with multiple comorbid conditions. Adhering to principles of user-centered design, we will develop and refine a toolkit to assess the feasibility of this approach. SN - 1748-5908 UR - https://www.unboundmedicine.com/medline/citation/24450385/Designing_and_evaluating_an_interprofessional_shared_decision_making_and_goal_setting_decision_aid_for_patients_with_diabetes_in_clinical_care__systematic_decision_aid_development_and_study_protocol_ L2 - https://implementationscience.biomedcentral.com/articles/10.1186/1748-5908-9-16 DB - PRIME DP - Unbound Medicine ER -