Feasibility of a randomized controlled trial to evaluate the impact of decision boxes on shared decision-making processes

BMC Medical Informatics and Decision Making

Research Article

Iqra Syed¹  R Brian Haynes²  Pierre Pluye³  Roland Grad⁴  Matthew Greenway⁵  Michel Cauchon⁶  France Légaré⁷  Michel Labrecque⁷  Pierre-Hugues Carmichael⁸  Anik MC Giguere⁹  Mélanie Martin⁹  Debi Banerjee^1,10 

[1]Department of Clinical Epidemiology and Biostatistics, McMaster University, 1280 Main Street West, CRL-125, L8S 4K1, Hamilton, ON, Canada

[2]Department of Clinical Epidemiology and Biostatistics, McMaster University, 1280 Main Street West, CRL-125, L8S 4K1, Hamilton, ON, Canada

[3]Department of Medicine, DeGroote School of Medicine, McMaster University, 1280 Main Street West, CRL-125, L8S 4K1, Hamilton, ON, Canada

[4]Department of Family Medicine, McGill University, 5858 Côte-des-neiges, 3rd Floor, Suite 300, H3S 1Z1, Montreal, QC, Canada

[5]Department of Family Medicine, McGill University, Herzl Family Practice Centre, 3755 Cote Sainte Catherine, QC H3T 1E2, Montreal, Canada

[6]Department of Family Medicine, McMaster University, 118 Lake Street, St. Catharines, ON, Canada

[7]Department of Family and Emergency Medicine, Laval University, Pavillon Ferdinand-Vandry, 1050 avenue de la Medecine, G1V 0A6, Quebec City, Quebec, Canada

[8]Department of Family and Emergency Medicine, Research Center of the CHU de Quebec, Saint-Francois d’Assise Hospital, Laval University, 10 rue de l’Espinay, D6-730, G1L 3L5, Quebec City, QC, Canada

[9]Research Centre for Excellence in Aging, CHU de Quebec, Saint-Sacrement Hospital, 1050 chemin Ste-Foy, G1S 4L8, Québec, Québec, Canada

[10]Research Centre for Excellence in Aging, CHU de Quebec, Saint-Sacrement Hospital, 1050 chemin Ste-Foy, G1S 4L8, Québec, Québec, Canada

[11]Department of Family and Emergency Medicine, Laval University, Pavillon Ferdinand-Vandry, 1050 avenue de la Medecine, G1V 0A6, Quebec City, Quebec, Canada

[12]The University of Toronto, Faculty of Medicine, 1 King’s College Circle, Medical Sciences Building (Rm. 2109), M5S-1A8, Toronto, ON, Canada

关键词: Evidence-based practice;    Continuing professional education;    Shared decision making;    Risk communication;    Patient-centered care;    Counseling;    Clinical topic summary;    Decision support;    Knowledge translation;   

DOI  :  10.1186/s12911-015-0134-x

 received in 2014-04-29, accepted in 2015-01-27,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundDecision boxes (DBoxes) are two-page evidence summaries to prepare clinicians for shared decision making (SDM). We sought to assess the feasibility of a clustered Randomized Controlled Trial (RCT) to evaluate their impact.MethodsA convenience sample of clinicians (nurses, physicians and residents) from six primary healthcare clinics who received eight DBoxes and rated their interest in the topic and satisfaction. After consultations, their patients rated their involvement in decision-making processes (SDM-Q-9 instrument). We measured clinic and clinician recruitment rates, questionnaire completion rates, patient eligibility rates, and estimated the RCT needed sample size.ResultsAmong the 20 family medicine clinics invited to participate in this study, four agreed to participate, giving an overall recruitment rate of 20%. Of 148 clinicians invited to the study, 93 participated (63%). Clinicians rated an interest in the topics ranging 6.4-8.2 out of 10 (with 10 highest) and a satisfaction with DBoxes of 4 or 5 out of 5 (with 5 highest) for 81% DBoxes. For the future RCT, we estimated that a sample size of 320 patients would allow detecting a 9% mean difference in the SDM-Q-9 ratings between our two arms (0.02 ICC; 0.05 significance level; 80% power).ConclusionsClinicians’ recruitment and questionnaire completion rates support the feasibility of the planned RCT. The level of interest of participants for the DBox topics, and their level of satisfaction with the Dboxes demonstrate the acceptability of the intervention. Processes to recruit clinics and patients should be optimized.

【 授权许可】

CC BY   
© Giguere et al.; licensee BioMed Central. 2015