Evaluation of the quality of patient information to support informed shared decision‐making

Abstract

Objectives (a) To ®nd out how much patient information material on display in family physicians' oces refers to management choices, and hence may be useful to support informed and shared decision-making (ISDM) by patients and (b) to evaluate the quality of print information materials exchanged during the consultation, i.e. brought in by patients or given out by family physicians.Design All print information available for patients and exchanged between physicians and patients was collected in a single complete day of the oce practices of 21 family physicians. A published and validated instrument (DISCERN) was used to assess quality.Setting and participants Community oce practices in the greater Vancouver area, British Columbia, Canada. The physicians were purposefully recruited by their association with the medical school Department of Family Practice, their interest in providing patients with print information and their representation of a range of practice types and location.Main variables studied The source of the pamphlets and these categories: available in the physicians' oces; exchanged between physician and patient; and produced with the explicit or apparent intent to support evidence-based patient choice. Main outcome measuresThe quality of the print information to support ISDM, as measured by DISCERN and the ease of use and reliability of the DISCERN tool.Results and conclusions Fewer than 50% of pamphlets available in these oces ful®lled our minimum criteria for ISDM (mentioned more than one management option). Oces varied widely in the proportion of pamphlets on display that supported ISDM and how particular the physician was in selecting materials. The DISCERN tool is quick, valid and reliable for the evaluation of patient information. The quality of patient information materials used in the consultation and available in these oces was below midpoint on the DISCERN score. Major de®ciencies were with respect to the mention of choices, risks, eect of no treatment or uncertainty and reliability (source, evidence-base). Good quality information can be produced; some is available locally.

Assisting parents of children with autism to make intervention decisions by improving their health literacy about evidence

“…SDM principles seek to empower the individual (or parent) to make decisions, based on the provision of quality health information (Charles et al, 1997;Coulter & Ellins, 2007) and their own personal preferences (Godolphin et al, 2001). For SDM to be effective, sufficient time within consultations is required to allow for a full discussion of client preferences, concerns, and any other information relevant to the individual's health condition (Thistlethwaite, 2006).…”

“…Some parents feel that they were given insufficient information from paediatricians at the time of their child's diagnosis (Osborne & Reed, 2008). With the limited time health practitioners have to spend with their clients (Kertoy, 2011;McMullan, 2005), they may not be able to adequately impart the information that is required for parents to make informed decisions (Godolphin, Towle, & McKendry, 2001, Hawk & Evans, 2013. Furthermore, some observations in the literature suggest that there are practitioners who avoid providing too much information for fear of overwhelming their clients with information .…”

“…Other parents of children with autism were a source of information for 72% of parents, compared to less than half (48%) who obtained information from health professionals (specifically physicians) (Mackintosh et al, 2005;Miller et al, 2011). The Web is always available, whereas health professionals have limited time, and may not be able to adequately impart all of the information that is required to assist parents to make informed decisions about interventions for their child (Godolphin, Towle and McKendry, 2001). …”

“…Screening health information using the DISCERN tool can assist individuals to participate in treatment decisions, and make better informed decisions about treatment options based on the quality of information and good evidence (Charnock, 1998). The inclusion of an item about whether the information provides support for shared decision making in a tool such as the DISCERN further supports the current trend towards patients becoming increasingly involved in their own treatment choices (Charnock, 1998;Elwyn et al, 2013;Godolphin et al, 2001). The current study aimed to analyse the quality of a sample of autism-related websites, in particular treatment information, using a valid and reliable health information evaluation tool.…”

Critical Issues for Psychiatric Medication Shared Decision Making with Youth and Families

“…This is particularly important given the potential disagreements between youth and their parents regarding treatment decisions. In a survey with 258 family medical students at the University of British Columbia, investigators found that conflict resolution and dealing with significant others, including parents, were two of the most challenging problems for SDM (Godolphin, Towle, & McKendry, 2001a, 2001b. Parents and youth may differ in their perceptions of involvement in the decision-making process.…”