Marie-Eve Poitras1,2,3, France Légaré4,5, Vanessa Tremblay Vaillancourt6,7,8, Isabelle Godbout9, Annie Poirier10, Karina Prévost7, Claude Spence6, Maud-Christine Chouinard11, Hervé Tchala Vignon Zomahoun12,13, Lobna Khadhraoui14, José Massougbodji14, Mathieu Bujold15, Pierre Pluye15, Catherine Hudon6,16. 1. Department of Family Medicine and Emergency Medicine/Nursing School, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Campus Saguenay, Saguenay, QC, Canada. marie-eve.poitras@usherbrooke.ca. 2. Département de la recherche, Centre Intégré Universitaire de Santé et de Services Sociaux du Saguenay-Lac-Saint-Jean, Saguenay, QC, Canada. marie-eve.poitras@usherbrooke.ca. 3. Centre de Recherche Charles-LeMoyne-Saguenay-Lac-Saint-Jean Sur Les Innovations en Santé, Saguenay, QC, Canada. marie-eve.poitras@usherbrooke.ca. 4. Department of Family Medicine and Emergency Medicine, Université Laval, Québec, QC, Canada. 5. Population Health and Practice-Changing Research, CHU de Québec, Université Laval, Québec, QC, Canada. 6. Department of Family Medicine and Emergency Medicine/Nursing School, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Campus Saguenay, Saguenay, QC, Canada. 7. Département de la recherche, Centre Intégré Universitaire de Santé et de Services Sociaux du Saguenay-Lac-Saint-Jean, Saguenay, QC, Canada. 8. Centre de Recherche Charles-LeMoyne-Saguenay-Lac-Saint-Jean Sur Les Innovations en Santé, Saguenay, QC, Canada. 9. Québec SPOR Support Unit, Université du Québec à Montréal, Montréal, QC, Canada. 10. Université Laval, Québec, QC, Canada. 11. Department of Health Sciences, Université du Québec à Chicoutimi, Saguenay, QC, Canada. 12. Department of Social and Preventive Medicine, Université Laval, Québec, QC, Canada. 13. Centre de Recherche sur ses Soins et les Services de Première Ligne, Université Laval, Québec, QC, Canada. 14. Quebec SPOR Support Unit, Université Laval, Québec, QC, Canada. 15. Family Medicine Department, McGill University, Montréal, QC, Canada. 16. Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Université de Sherbrooke, Sherbrooke, QC, Canada.
Abstract
BACKGROUND: Some patients with complex healthcare needs become high users of healthcare services. Case management allows these patients and their interprofessional team to work together to evaluate their needs, priorities and available resources. High-user patients must make an informed decision when choosing whether to engage in case management and currently there is no tool to support them. OBJECTIVE: The objective of this study was to develop and conduct a pilot alpha testing of a patient decision aid that supports high-user patients with complex needs and the teams who guide those patients in shared decision making when engaging in case management. METHODS: We chose a user-centered design to co-develop a patient decision aid with stakeholders informed by the Ottawa Research Institute and International Patient Decision Aid Standards frameworks. Perceptions and preferences for the patient decision aid's content and format were assessed with patients and clinicians and were iteratively collected through interviews and focus groups. We developed a prototype and assessed its acceptability by using a think-aloud method and a questionnaire with three patient-partners, six clinicians and seven high-user patients with complex needs. RESULTS: The three rounds of evaluation to assess the decision aid's acceptability highlighted comments related to simplicity, readability and visual aspect. A section presenting clinical vignettes including story telling was identified as the most helpful. CONCLUSIONS: We created and evaluated a patient decision aid. Considering the positive comments, we believe that this aid has the potential to help high-user patients with complex care needs make better choices concerning case management.
BACKGROUND: Some patients with complex healthcare needs become high users of healthcare services. Case management allows these patients and their interprofessional team to work together to evaluate their needs, priorities and available resources. High-user patients must make an informed decision when choosing whether to engage in case management and currently there is no tool to support them. OBJECTIVE: The objective of this study was to develop and conduct a pilot alpha testing of a patient decision aid that supports high-user patients with complex needs and the teams who guide those patients in shared decision making when engaging in case management. METHODS: We chose a user-centered design to co-develop a patient decision aid with stakeholders informed by the Ottawa Research Institute and International Patient Decision Aid Standards frameworks. Perceptions and preferences for the patient decision aid's content and format were assessed with patients and clinicians and were iteratively collected through interviews and focus groups. We developed a prototype and assessed its acceptability by using a think-aloud method and a questionnaire with three patient-partners, six clinicians and seven high-user patients with complex needs. RESULTS: The three rounds of evaluation to assess the decision aid's acceptability highlighted comments related to simplicity, readability and visual aspect. A section presenting clinical vignettes including story telling was identified as the most helpful. CONCLUSIONS: We created and evaluated a patient decision aid. Considering the positive comments, we believe that this aid has the potential to help high-user patients with complex care needs make better choices concerning case management.