JMIR Publications

ABSTRACT

Background:

The ‘Everyday Shared Decision Making’ approach (ESDM) was developed as a more feasible approach to personalizing decisions in primary care. This approach includes 3 key elements: 1) making a tailored recommendation, 2) qualitatively presenting tradeoffs, and 3) supporting patient decisional autonomy. Previous work found this approach to be acceptable. However, little is known about how the Everyday SDM approach can be integrated within the primary care setting.

Objective:

To describe the protocol for a pilot test of the feasibility and acceptability, to both patients and primary care clinicians (PCCs), of using a paper-based deployment of the Everyday SDM approach in the primary care clinic.

Methods:

Two case studies were examined: lung cancer screening (LCS) and blood pressure (BP) treatment decisions. This study was a multi-component pilot implementation study involving training PCCs in the Everyday SDM approach and providing them with an encounter-based Decision Aid supporting the Everyday SDM approach during clinic visits. Eligible patients were either candidates for an initial lung cancer screening conversation or a conversation about intensifying blood pressure medication. The patient-PCC medical encounters were audio-recorded. Following the appointment, the patient completed a short survey and semi-structured interview. After PCCs completed 2-3 study appointments, they completed a semi-structured interview reflecting on their experience with the Everyday SDM approach.

Results:

We recruited 10 PCCs and 23 patients (4 LCS patients and 19 BP patients). Data analysis is currently ongoing.

Conclusions:

The results from this pilot study will contribute to the ongoing efforts towards integrating a practical approach to SDM into primary care. This pilot will lay the groundwork for an effective and efficient larger-scale trial.