Shared decision making in West Africa: The forgotten area

Diouf, Ndeye Thiab; Charif, Ali Ben; Adisso, Lionel; Adekpedjou, Rhéda; Zomahoun, Hervé Tchala Vignon; Agbadjé, Titilayo Tatiana; Dogba, Mama Joyce; Garvelink, Mirjam M.

doi:10.1016/j.zefq.2017.05.013

Cited by 10 publications

(7 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Further research should test their usefulness in clinical practice and especially in interprofessional teams, as well as design implementation strategies. Third, our results confirm other studies showing that it is necessary to encourage the practice of SDM in African and other low-income countries, where few SDM tools are available, 44 45 in order to reduce global inequities in patient-centred care.…”

Section: Discussionsupporting

confidence: 88%

Decision aids for home and community care: a systematic review

Lognon

Plourde

Aubin³

et al. 2022

BMJ Open

View full text Add to dashboard Cite

ObjectivesDecision aids (DAs) for clients in home and community care can support shared decision-making (SDM) with patients, healthcare teams and informal caregivers. We aimed to identify DAs developed for home and community care, verify their adherence to international DA criteria and explore the involvement of interprofessional teams in their development and use.DesignSystematic review reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Data sourcesSix electronic bibliographic databases (MEDLINE, Embase, CINAHL Plus, Web of Science, PsycINFO and the Cochrane Library) from inception to November 2019, social media and grey literature websites up to January 2021.Eligibility criteriaDAs designed for home and community care settings or including home care or community services as options.Data extraction and synthesisTwo reviewers independently reviewed citations. Analysis consisted of a narrative synthesis of outcomes and a thematic analysis. DAs were appraised using the International Patient Decision Aid Standards (IPDAS). We collected information on the involvement of interprofessional teams, including nurses, in their development and use.ResultsAfter reviewing 10 337 database citations and 924 grey literature citations, we extracted characteristics of 33 included DAs. DAs addressed a variety of decision points. Nearly half (42%) were relevant to older adults. Several DAs did not meet IPDAS criteria. Involvement of nurses and interprofessional teams in the development and use of DAs was minimal (33.3% of DAs).ConclusionDAs concerned a variety of decisions, especially those related to older people. This reflects the complexity of decisions and need for better support in this sector. There is little evidence about the involvement of interprofessional teams in the development and use of DAs in home and community care settings. An interprofessional approach to designing DAs for home care could facilitate SDM with people being cared for by teams.PROSPERO registration numberCRD42020169450.

show abstract

Section: Discussionsupporting

confidence: 88%

Decision aids for home and community care: a systematic review

Lognon

Plourde

Aubin³

et al. 2022

BMJ Open

View full text Add to dashboard Cite

show abstract

“…Informal caregivers in low- or middle-income countries, for example, may have very different health-related preferences, perceptions, and options. 63…”

Section: Discussionmentioning

confidence: 99%

Decision Regret among Informal Caregivers Making Housing Decisions for Older Adults with Cognitive Impairment: A Cross-sectional Analysis

Elidor¹,

Charif

Djade³

et al. 2020

Med Decis Making

Self Cite

View full text Add to dashboard Cite

Background. Informal caregivers are regularly faced with difficult housing decisions for older adults with cognitive impairment. They often regret the decision they made. We aimed to identify factors associated with decision regret among informal caregivers engaging in housing decisions for cognitively impaired older adults. Methods. We performed a secondary analysis of cross-sectional data collected from a cluster-randomized trial. Eligible participants were informal caregivers involved in making housing decisions for cognitively impaired older adults. Decision regret was assessed after caregivers’ enrollment in the study using the Decision Regret Scale (DRS), scored from 0 to 100. We used a conceptual framework of potential predictors of regret to identify independent variables. We performed multilevel analyses using a mixed linear model by estimating fixed effects (β) and 95% confidence intervals (CIs). Results. The mean (SD) DRS score of 296 informal caregivers (mean [SD] age, 62 [12] years) was 12.4 (18.4). Factors associated with less decision regret were having a college degree compared to primary education (β [95% CI]: –11.14 [–18.36, –3.92]), being married compared to being single (–5.60 [–10.05, –1.15]), informal caregivers’ perception that a joint process occurred (–0.14 [–0.25, –0.02]), and older adults’ not having a specific housing preference compared to preferring to stay at home (–4.13 [–7.40, –0.86]). Factors associated with more decision regret were being retired compared to being a homemaker (7.74 [1.32, 14.16]), higher burden of care (0.14 [0.05, 0.22]), and higher decisional conflict (0.51 [0.34, 0.67]). Limitations. Our analysis may not illustrate all predictors of decision regret among informal caregivers. Conclusions. Our findings will allow risk-mitigation strategies for informal caregivers at risk of experiencing regret.

show abstract

“…Remote care approaches such as telemedicine have become mainstream with the COVID-19 pandemic, and yet little is known about the feasibility and effectiveness of remote SDM approaches [27]. That there are more ways of caring and that the tools used in this study require little clinician training and no patient preparation may all contribute to promote SDM in diabetes care even where this expectation may be just evolving [28]. Also, it has become clear that adherence as an outcome measure is, like for other outcomes, quite sensitive to the prevalence of nonadherence at baseline [29].…”

Section: Implication For Practice Policy and Researchmentioning

confidence: 98%

Making sense of diabetes medication decisions: a mixed methods cluster randomized trial using a conversation aid intervention

et al. 2021

View full text Add to dashboard Cite

Purpose To determine the effectiveness of a shared decision-making (SDM) tool versus guideline-informed usual care in translating evidence into primary care, and to explore how use of the tool changed patient perspectives about diabetes medication decision making. Methods In this mixed methods multicenter cluster randomized trial, we included patients with type 2 diabetes mellitus and their primary care clinicians. We compared usual care with or without a within-encounter SDM conversation aid. We assessed participant-reported decisions made and quality of SDM (knowledge, satisfaction, and decisional conflict), clinical outcomes, adherence, and observer-based patient involvement in decision-making (OPTION12-scale). We used semi-structured interviews with patients to understand their perspectives. Results We enrolled 350 patients and 99 clinicians from 20 practices and interviewed 26 patients. Use of the conversation aid increased post-encounter patient knowledge (correct answers, 52% vs. 45%, p = 0.02) and clinician involvement of patients (Mean between-arm difference in OPTION12, 7.3 (95% CI 3, 12); p = 0.003). There were no between-arm differences in treatment choice, patient or clinician satisfaction, encounter length, medication adherence, or glycemic control. Qualitative analyses highlighted differences in how clinicians involved patients in decision making, with intervention patients noting how clinicians guided them through conversations using factors important to them. Conclusions Using an SDM conversation aid improved patient knowledge and involvement in SDM without impacting treatment choice, encounter length, medication adherence or improved diabetes control in patients with type 2 diabetes. Future interventions may need to focus specifically on patients with signs of poor treatment fit. Clinical trial registration ClinicalTrial.gov: NCT01502891.

show abstract

Shared decision making in West Africa: The forgotten area

Cited by 10 publications

References 16 publications

Decision aids for home and community care: a systematic review

Decision aids for home and community care: a systematic review

Decision Regret among Informal Caregivers Making Housing Decisions for Older Adults with Cognitive Impairment: A Cross-sectional Analysis

Making sense of diabetes medication decisions: a mixed methods cluster randomized trial using a conversation aid intervention

Contact Info

Product

Resources

About