Patients’ views on the use of an Option Grid for knee osteoarthritis in physiotherapy clinical encounters: An interview study

Kinsey, Katharine; Firth, Jill; Elwyn, Glyn; Edwards, Adrian; Brain, Katherine Emma; Marrin, Katy; Nye, Alan; Wood, Fiona

doi:10.1111/hex.12570

Cited by 19 publications

(11 citation statements)

References 26 publications

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“…Our findings support the current perception that written information facilitates SDM in the ED . Finally, those looking to facilitate SDM in their clinical practice should consider how to best utilize friends and family as active participants, as most participants in our study felt these allies would be helpful.…”

Section: Discussionsupporting

confidence: 85%

Patient Preferences Regarding Shared Decision Making in the Emergency Department: Findings From a Multisite Survey

Schoenfeld¹,

Kanzaria

Quigley

et al. 2018

Academic Emergency Medicine

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We found that the majority of ED patients in our large, diverse sample wanted to be involved in medical decisions, especially in the case of a "serious" medical problem, and felt that they had the ability to do so. Nevertheless, many patients were unlikely to actively seek involvement and defaulted to allowing the physician to make decisions during the ED visit. After fully explaining the consequences of a decision, clinicians should make an effort to explicitly ascertain patients' desired level of involvement in decision making.

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Section: Discussionsupporting

confidence: 85%

Patient Preferences Regarding Shared Decision Making in the Emergency Department: Findings From a Multisite Survey

Schoenfeld¹,

Kanzaria

Quigley

et al. 2018

Academic Emergency Medicine

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“…Our study supports previous findings that decision aids are acceptable tools [25]. Despite variation on surgery choice, most wanted an active role in SDM and the surgeon's recommendation.…”

Section: Discussionsupporting

confidence: 88%

“…One way to support SDM is through decision aids, such as Option Grids, providing accurate and accessible information [25]. Option Grids are one-page evidence-based summaries of available options presented in a table format with frequently asked questions (FAQs) listed as the rows derived from common concerns allowing horizontal comparison between options [18].…”

Section: Introductionmentioning

confidence: 99%

“…Most importantly, they are developed collaboratively with multidisciplinary clinical teams and patients [28]. Recent research suggests both patients and clinicians find them acceptable and practical and should be considered within routine consultations [25,29,30]. This study consulted the Option Grid guidelines on developing a decision aid.…”

Section: Introductionmentioning

confidence: 99%

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Partial or total knee replacement? Identifying patients’ information needs on knee replacement surgery: a qualitative study to inform a decision aid

et al. 2019

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Purpose For patients with end-stage knee osteoarthritis, joint replacement is a widely used and successful operation to help improve quality-of-life when non-operative measures have failed. For a significant proportion of patients there is a choice between a partial or total knee replacement. Decision aids can help people weigh up the need for and benefits of treatment against possible risks and side-effects. This study explored patients' experiences of deciding to undergo knee replacement surgery to identify information priorities, to inform a knee replacement decision aid. Methods Four focus groups were held with 31 patients who were candidates for both partial and total knee replacement surgery. Two focus groups included patients with no prior knee replacement surgery (pre-surgery); two with patients with one knee already replaced and who were candidates for a second surgery on their other knee (post-surgery). Data were analysed using Framework Analysis. Results Participants described a process of arriving at 'readiness for surgery' a turning point where the need for treatment outweighed their concerns. Referral and personal factors influenced their decision-making and expectations of surgery in the hope to return to a former self. Those with previous knee surgery offered insights into whether their expectations were met. 'Information for decisions' details the practicality and the optimal timing for the delivery of a knee replacement decision aid. In particular, participants would have valued hearing about the experiences of other patients and seeing detailed pictures of both surgical options. Information priorities were identified to include in a decision aid for knee replacement surgery. Conclusions Patients' experiences of surgical decision-making have much in common with the Necessity-Concerns Framework. Whilst originally developed to understand drug treatment decisions and adherence, it provides a useful lens to understand decision-making about surgery. The use of a decision aid could enhance decision-making on knee replacement surgery. Ultimately, patients' understanding of the risks and benefits of both surgical options could be improved and in turn, help informed decision-making. The knee replacement decision aid is perceived as a useful tool to be associated with other detailed information resources as recommended.

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“…Although SDM is now widely advocated in policy, it is still not routinely implemented in practice. Studies have highlighted many system, clinician and patient barriers to its routine use . System barriers include time pressures, concern about disruption to established workflows and lack of incentives rewarding SDM .…”

Section: Introductionmentioning

confidence: 99%

“What would you recommend doctor?”—Discourse analysis of a moment of dissonance when sharing decisions in clinical consultations

Sherlock

Wood

Joseph‐Williams

et al. 2019

Health Expectations

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Background Proven benefits of Shared Decision Making (SDM) include improved patient knowledge, involvement and confidence in making decisions. Although widely advocated in policy, SDM is still not widely implemented in practice. A common patient‐reported barrier is feeling that “doctor knows best”; thus, patients often defer decisions to the clinician. Objective To examine the nature of the discourse when patients ask clinicians for a treatment recommendation during consultations when treatment decisions are being shared and to examine clinicians’ strategies used in response. Design, Setting and Participants Theme‐orientated discourse analysis was performed on eight audio‐recordings of breast cancer diagnostic consultations in which patients or their partners attempted to defer treatment decisions to the clinician. Clinicians were trained in SDM. Results Tension was evident in a number of consultations when treatment recommendations were requested. Clinicians responded to recommendation requests by explaining why the decision was being shared (personal nature of the decision, individual preferences and equivalent survival outcomes of treatment options). There was only one instance where a clinician gave a treatment recommendation. Discussion and Conclusions Strategies for clinicians to facilitate SDM when patients seem to defer decisional responsibility include being clear about why the decision is being shared, acknowledging that this is difficult and making patients feel supported. When patients seek guidance, clinicians can provide a recommendation if grounded in an understanding of the patient's values.

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Patients’ views on the use of an Option Grid for knee osteoarthritis in physiotherapy clinical encounters: An interview study

Cited by 19 publications

References 26 publications

Patient Preferences Regarding Shared Decision Making in the Emergency Department: Findings From a Multisite Survey

Patient Preferences Regarding Shared Decision Making in the Emergency Department: Findings From a Multisite Survey

Partial or total knee replacement? Identifying patients’ information needs on knee replacement surgery: a qualitative study to inform a decision aid

“What would you recommend doctor?”—Discourse analysis of a moment of dissonance when sharing decisions in clinical consultations

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