An Impressive and Wide-Ranging Collection of Shared Decision Making Tools Just a Few Clicks Away
Last week, one of my most favorite and most non-compliant patients showed up for a walk-in appointment after missing months of care during the COVID-19 pandemic. By the end of the visit, the patient was back on her thyroid medication and osteoporosis medications, started high blood pressure and high cholesterol medication (after nearly a year of needling), and scheduled her mammogram and CT lung cancer and completed lab work and her FIT test — all in a 20-minute appointment.
One thing that helped in making some of these discussions quicker and easier was the Patient Decision Aids website. Using my handy USPSTF app to show the patient everything that was recommended for her based on her demographics, I used the tools from the Patient Decision Aids website to help the patient make the (right) decisions regarding taking high blood pressure and high cholesterol medications.
I still couldn’t convince her to stop smoking, but otherwise, the visit seemed successful.
Obviously, follow-up will be key to see if the patient keeps on taking these medicines, completes her screening tests, etc. This is frankly a typical appointment in primary care.
Having tools to help these vital and complex discussions is critically important. The Ottawa Hospital Research Institute was founded in 1995, but I only recently became aware of its existence. Many of us have used some of Ottawa MSK rules, but there is a website with a collection of hundreds of shared decision making aids. The mission of the group is to help patients make these “tough decisions.” The defined “tough decisions” as those that have multiple options, uncertain outcomes, and benefits and harms that people value differently.
The group has collected evidence showing the effectiveness of using patient decision aids for these tough decisions.
The website links to numerous studies including this systematic review that is continuously updated showing their efficacy. The website’s primary utility to most physicians is the A to Z inventory of all the decision aids; you can also just type what you are looking for into the search window. It also houses their developmental toolkit containing everything you need to build and evaluate your own decision aid and a detailed implementation toolkit including how to link it to their clearinghouse. Some examples of the decision aids included in the A to Z inventory include: “Allergy: Should I take allergy shots?” “Atrial fibrillation: Should I take an anticoagulant to prevent stroke?” “Breast cancer: When should I start mammograms,” and “cholesterol: should I take statins?”
Patient Decision Aids contains evidence based shared decision making tools on hundreds of topics. The website does not house really any of the tools, but summarizes them using a unique toolkit and then links to the site where the tool is kept. The website has an entire section dedicated to the evidence supporting the use of patient decision aids.
What providers would benefit from this App?
Students, residents, mid-levels, Family Medicine, Internal Medicine, primary care, and any provider who wants to improve the shared decision making with patients.
- Easy to follow, answers the most common questions about all forms of contraception
- Ability for patients to create a unique birth control profile
- Unique deployment-related content yet still applicable to all women
- Some links do not work
- Requires use of hyperlinks to reach each tool
- No native apps available for iOS or Android
Patient Decision Aids from the Ottawa Hospital Research Institute is the largest collection yet of high quality tools for shared decision making. They cover topics from COVID, to hyperlipidemia, to osteoporosis and hundreds of aids in total. The website works relatively well as a webapp, but begs for a native iOS or Android app for quick reference. Nonetheless, this collection should be at the fingertips of every primary care provider to help educate patients in making the best, most informed decisions about a great variety of topics. Highly recommended.
o 4.5 stars
o 4.0 stars
Would benefit from a more mobile-friendly/efficient experience. However, it works well enough to scroll/type and search through the many many decision aids available.
o 4.0 stars
All patient decision aids are housed on the websites of the owner/create so extensive hyperlinking throughout the sight. Some links are dead ends, but most work well.
o 5 stars
Website is free!
o 5.0 stars
Ideally, this website could be used at every patient encounter to help with shared decision making. Unfortunately, in a busy primary care practice, I suspect this will remain challenging. However, this site is a comprehensive and ever-growing collection of patient decision aids to use at the point of care.
Device Used For Review
o iPhone 11Pro running iOS 13.6.1
Website; no native app for iPhone or Android available at this time.
Disclaimer: The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. Government.