Evaluating decision aids – where next?
Article first published online: 29 APR 2004
Volume 7, Issue 2, pages 98–103, June 2004
How to Cite
O'Cathain, A. and Thomas, K. J. (2004), Evaluating decision aids – where next?. Health Expectations, 7: 98–103. doi: 10.1111/j.1369-7625.2004.00258.x
- Issue published online: 29 APR 2004
- Article first published online: 29 APR 2004
- Accepted for publication 20 October 2003
- barriers to implementation;
- decision aids;
- pragmatic randomized controlled trials
Decision aids have been developed to help patients become involved in decision-making about their individual health care. During the evaluation of a particular decision aid in maternity care – a set of 10 ‘Informed Choice’ leaflets – we considered the lessons learnt for evaluation of decision aids in the future. Decision aids have been tested mainly in explanatory trials and have been found to be effective. We argue that existing decision aids should be subjected to more pragmatic trials to test their effectiveness in the real world. The small amount of evidence on their use in the real world shows that they face challenges, resulting in poor implementation. Therefore, we propose that implementation strategies are developed which take heed of the findings of research on getting evidence into practice, and in particular address structural barriers such as the lack of time available to health professionals. We recommend that these ‘decision aid implementation packages’ are developed in conjunction with both health professionals and patients, and identify and address potential barriers to both the delivery of patient involvement in decision-making, and the use of decision aids, in the real world. These ‘packages’ can then be submitted to pragmatic evaluation.