Promoting decision aid use in primary care using a staff member for delivery.

OBJECTIVE: To determine the feasibility and effectiveness of in-clinic decision aid distribution using a care assistant. METHODS: We identified potentially eligible patients scheduled for upcoming appointments in our General Internal Medicine Clinic (n=1229). Patients were deemed eligible for two decision aids: prostate cancer screening and/or weight loss surgery. Patients were approached to view the decision aid in-clinic. Our primary measures were the proportion of decision aids distributed to eligible patients, and the proportion of decision aids viewed. RESULTS: Among 913 patients who attended their scheduled appointments, 58% (n=525) were approached and eligibility was assessed by the staff member. Among the 471 who remained eligible, 57% (n=268) viewed at least a portion of the target decision aid. The mean viewing time for patients who watched less than the complete decision aid was 13 min. CONCLUSIONS: In clinic viewing of decision aids may be a feasible and effective distribution method in primary care. PRACTICE IMPLICATIONS: In clinic distribution requires an electronic health information system to identify potentially eligible patients, and a staff member dedicated to DA distribution. Brief decision aids (less than 10 min) are needed so patients can complete their use prior to the visit to facilitate patient-physician decision making.

Duke Scholars

Author Michael Patrick Pignone Medicine, General Internal Medicine