Helping patients make informed healthcare decisions

Helping patients make informed healthcare decisions

Vanessa Jordan
PEARLS No.
740
Clinical question

Do patient decision aids effectively help people reach informed decisions regarding their healthcare needs?

Bottom line

Compared with usual care, across a wide variety of decisions, patient decision aids likely resulted in better congruence between participants’ informed values for features of options and the choice made(there was moderate-certainty evidence that they helped more adults choose an option that reflected what was most important to them).

Patient decision aids also resulted in large increases in knowledge, accurate risk perceptions and increased participation in decision-making. There was reduced decisional conflict for subscales of feeling uninformed and having unclear personal values.

Consultations were no longer in duration when patient decision aids were used in preparation for the consultation, and they were only 1.5 minutes longer when decision aids were used during the consultation.

Caveat

No studies demonstrated adverse effects in patients exposed to patient decision aids compared with usual care, as indicated by no increase in decision regret or emotional distress.

However, there continues to be inadequate evidence on adherence to the chosen option and on healthcare system effects (eg, cost and resource use). No studies measured preference-linked health outcomes.

Context

Patient decision aids are interventions designed to support people making health decisions when there is more than one option, including status quo (no change). They are pamphlets, videos or web-based resources that clearly identify the healthcare decision to be made, provide evidence-based information about the options and associated benefits and harms, and help people clarify which features of the options are most important to them.

Decision aids are designed to enhance and supplement consultation with the clinician, not replace it.

Cochrane Systematic Review

Stacey D, et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev 2024;1:CD001431. This review contains 209 trials with a total of 107,698 participants.