Assignment: Explored Provider Perspectives
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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