Decision aids to help people who are facing health treatment or screening decisions
Identifying and making a decision on the best health treatment or screening option can be difficult for patients. Decision aids can be used when there is more than one reasonable option, when no option has a clear advantage in terms of health outcomes, and when each option has benefits and harms that patients may value differently. Decision aids may be pamphlets, videos, or web-based tools. They describe the options available and help people to understand these options as well as the possible benefits and harms. This allows patients to consider the options from a personal view (e.g. how important the possible benefits and harms are to them) and prepares them to participate with their health practitioner in making a decision.
The updated review of 86 studies found that when patients use decision aids they: a) improve their knowledge of the options; b) are helped to have more accurate expectations of possible benefits and harms; c) reach choices that are more consistent with their informed values; and d) participate more in decision making. Decision aids have a variable effect on actual choices but they reduce the choice of elective surgery when patients consider other options. When patients use decision aids, there appears to be a positive effect on communication with their health practitioner, and a variable effect on the time required for this consultation. Although there is an improvement with more detailed decision aids compared to simpler decision aid, the amount of improvement is smaller than that seen when decision aids are compared to usual care. There are no apparent adverse effects on health outcomes or satisfaction. More research is needed to evaluate adherence with the chosen option, patient-practitioner communication, and the associated costs.