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Understanding and overcoming the barriers of implementing patient decision aids in clinical practice* 

Authors

  • Siobhan O'Donnell BScPT MSc,

    Corresponding author
    1. Research Coordinator, Clinical Epidemiology Program, Ottawa Health Research Institute, Ottawa, Ontario, Canada
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  • Ann Cranney MD MSc,

    1. Scientist, Clinical Epidemiology Program, Ottawa Health Research Institute; Rheumatologist, Ottawa Hospital; Associate Professor, Medicine, Epidemiology and Community Medicine, University of Ottawa; CIHR New Investigator, Ottawa, Ontario, Canada
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  • Mary J. Jacobsen RN Med,

    1. Clinical Research Associate, Clinical Epidemiology Program, Ottawa Health Research Institute; Clinical Lecturer, Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
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  • Ian D. Graham PhD,

    1. Senior Social Scientist and Associate Director, Clinical Epidemiology Program, Ottawa Health Research Institute; Associate Professor, School of Nursing, Medicine, Epidemiology and Community Medicine, University of Ottawa; CIHR New Investigator, Ottawa, Ontario, Canada
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  • Annette M. O'Connor RN PhD,

    1. Senior Scientist, Clinical Epidemiology Program, Ottawa Health Research Institute; Professor, School of Nursing, Epidemiology and Community Medicine, University of Ottawa; Tier 1 Canada Research Chair in Health Care Consumer Decision Support, Ottawa, Ontario, Canada
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  • Peter Tugwell MD MSc

    1. Senior Scientist, Clinical Epidemiology Program, Ottawa Health Research Institute; Scientist, Institute for Population Health, University of Ottawa; Professor, Medicine, Epidemiology and Community Medicine, University of Ottawa; Tier 1 Canada Research Chair in Health Equity, Ottawa, Ontario, Canada
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  • * 

    The work was carried out in the following institution: Ottawa Health Research Institute, Clinical Epidemiology Program, 1053 Carling Avenue, Ottawa ON Canada K1Y 4E9.

Siobhan O’Donnell
Ottawa Health Research Institute
Clinical Epidemiology Program
1053 Carling Avenue, C-414
Ottawa Ont.
Canada K1Y 4E9
E-mail: sodonnell@ohri.ca

Abstract

Patient decision aids (ptDAs) have been developed to assist patients with difficult health-related decisions. Despite their proven effects on decision quality in numerous efficacy trials, we lack an evidence-based approach for implementing them as part of the process of care. Pragmatic trials of ptDAs have uncovered a myriad of implementation challenges; therefore we need a better understanding of the barriers and strategies to overcome them to facilitate their widespread uptake. The following paper provides an overview of the barriers related to the uptake of ptDAs within the process of care and the strategies, opportunities and research priorities to overcome them. This report is based on our interpretation of the literature and our collective experience in implementing ptDAs within trials and other contexts.

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