Quality and effectiveness of osteoporosis treatment decision aids: a systematic review and environmental scan
- 5 June 2020
- journal article
- review article
- Published by Springer Science and Business Media LLC in Osteoporosis International
- Vol. 31 (10), 1837-1851
- https://doi.org/10.1007/s00198-020-05479-w
Abstract
Decision aids (DAs) are evidence-based tools that support shared decision-making (SDM) implementation in practice; this study aimed to identify existing osteoporosis DAs and assess their quality and efficacy; and to gain feedback from a patient advisory group on findings and implications for further research. We searched multiple bibliographic databases to identify research studies from 2000 to 2019 and undertook an environmental scan (search conducted February 2019, repeated in March 2020). A pair of reviewers, working independently selected studies for inclusion, extracted data, evaluated each trial’s risk of bias, and conducted DA quality assessment using the International Patient Decision Aid Standards (IPDAS). Public contributors (patients and caregivers with experience of osteoporosis and fragility fractures) participated in discussion groups to review a sample of DAs, express preferences for a new DA, and discuss plans for development of a new DA. We identified 6 studies, with high or unclear risk of bias. Across included studies, use of an osteoporosis DA was reported to result in reduced decisional conflict compared with baseline, increased SDM, and increased accuracy of patients’ perceived fracture risk compared with controls. Eleven DAs were identified, of which none met the full set of IPDAS criteria for certification for minimization of bias. Public contributors expressed preferences for encounter DAs that are individualized to patients’ own needs and risk. Using a systematic review and environmental scan, we identified 11 decision aids to inform patient decisions about osteoporosis treatment and 6 studies evaluating their effectiveness. Use of decision aids increased accuracy of risk perception and shared decision-making but the decision aids themselves fail to comprehensively meet international quality standards and patient needs, underpinning the need for new DA development.Keywords
Funding Information
- National Institute for Health Research (CS-2018-18-ST2-010)
This publication has 34 references indexed in Scilit:
- Encounter Decision Aid vs. Clinical Decision Support or Usual Care to Support Patient-Centered Treatment Decisions in Osteoporosis: The Osteoporosis Choice Randomized Trial IIPLOS ONE, 2015
- Impact of Sociodemographic Patient Characteristics on the Efficacy of Decision AidsCirculation: Cardiovascular Quality and Outcomes, 2014
- Abandoned Acid? Understanding Adherence to Bisphosphonate Medications for the Prevention of Osteoporosis among Older Women: A Qualitative Longitudinal StudyPLOS ONE, 2014
- A systematic development process for patient decision aidsBMC Medical Informatics and Decision Making, 2013
- Toward Minimum Standards for Certifying Patient Decision AidsMedical Decision Making, 2013
- Use of a Decision Aid to Improve Treatment Decisions in Osteoporosis: The Osteoporosis Choice Randomized TrialAmerican Journal Of Medicine, 2011
- Why Do Women Reject Bisphosphonates for Osteoporosis? A Videographic StudyPLOS ONE, 2011
- Investing in Deliberation: A Definition and Classification of Decision Support Interventions for People Facing Difficult Health DecisionsMedical Decision Making, 2010
- Protocol for the Osteoporosis Choice trial. A pilot randomized trial of a decision aid in primary care practiceTrials, 2009
- The impact of osteoporosis medication beliefs and side-effect experiences on non-adherence to oral bisphosphonatesCurrent Medical Research and Opinion, 2007