Implementation of a cystic fibrosis lung transplant referral patient decision aid in routine clinical practice: an observational study

Implementation Science : IS
Dawn StaceyShawn D Aaron

Abstract

The decision to have lung transplantation as treatment for end-stage lung disease from cystic fibrosis (CF) has benefits and serious risks. Although patient decision aids are effective interventions for helping patients reach a quality decision, little is known about implementing them in clinical practice. Our study evaluated a sustainable approach for implementing a patient decision aid for adults with CF considering referral for lung transplantation. A prospective pragmatic observational study was guided by the Knowledge-to-Action Framework. Healthcare professionals in all 23 Canadian CF clinics were eligible. We surveyed participants regarding perceived barriers and facilitators to patient decision aid use. Interventions tailored to address modifiable identified barriers included training, access to decision aids, and conference calls. The primary outcome was >80% use of the decision aid in year 2. Of 23 adult CF clinics, 18 participated (78.2%) and 13 had healthcare professionals attend training. Baseline barriers were healthcare professionals' inadequate knowledge for supporting patients making decisions (55%), clarifying patients' values for outcomes of options (58%), and helping patients handle conflicting views of other...Continue Reading

References

Feb 28, 2003·Lancet·Felix Ratjen, Gerd Döring
Mar 25, 2006·The Journal of Continuing Education in the Health Professions·Ian D GrahamNicole Robinson
Aug 16, 2006·BMJ : British Medical Journal·Glyn ElwynUNKNOWN International Patient Decision Aids Standards (IPDAS) Collaboration
Apr 10, 2008·BMJ : British Medical Journal·Henry McQuay
Apr 4, 2009·International Journal of Nursing Education Scholarship·Dawn StaceyAnnette M O'Connor
Jul 11, 2009·American Journal of Respiratory and Critical Care Medicine·Katherine L VandemheenShawn D Aaron
Nov 4, 2009·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Melissa BrouwersAnnette O'Connor
Apr 20, 2010·Progress in Transplantation : Official Publication, North American Transplant Coordinators Organization ... [et Al.]·Katherine L VandemheenAnnette O'Connor
Feb 7, 2012·Patient Education and Counseling·France LégaréUNKNOWN SDM-CPD Team
Jun 2, 2012·Implementation Science : IS·Jeremy M GrimshawJanet E Squires

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Citations

May 24, 2019·The Cochrane Database of Systematic Reviews·Helen MaloneImelda Coyne
Oct 3, 2019·International Anesthesiology Clinics·Warren A SoutherlandFred E Shapiro
Oct 1, 2019·Health Informatics Journal·Julia J van Tol-GeerdinkPeep Fm Stalmeier
Jun 7, 2017·Pediatric Rheumatology Online Journal·William B BrinkmanEsi Morgan
Dec 16, 2020·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Natalie Joseph-WilliamsTrudy van der Weijden
Jan 9, 2020·Current Opinion in Anaesthesiology·Warren A SoutherlandRichard D Urman
Mar 22, 2021·BMC Medical Informatics and Decision Making·Kristin M KostickJ S Blumenthal-Barby
May 12, 2021·Implementation Science : IS·Danielle SchubbeMarie-Anne Durand

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Software Mentioned

Decision Support Analysis Tool
SAS

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