Early Indications Human-Centered Decision Aids Help People Make More Appropriate Care Decisions

Geri Lynn Baumblatt,Mark Mulert,Jason Gottlieb

doi:10.2196/iproc.6223

Abstract

Background: Conditions like chronic low back, hip, and knee pain and low-risk prostate cancer are frequently over-treated. The Agency for Healthcare Research and Quality reports that for chronic low back pain, spinal fusion surgery increased from 61,000 in 1993 to 465,000 in 2011. This has not improved outcomes or reduced disability rates. Patients frequently catastrophize their pain and avoid beneficial activities like walking. Likewise, men with low-risk prostate cancer often react with fear and opt for more invasive treatments like surgery over active surveillance. These are often stressful decisions that patients do not make based solely on data and information but contain strong emotional factors as patients consider the tradeoffs and the short- and long-term effects on their lives and those of their partners and families. A previous randomized controlled trial showed that a multimedia program created with a human-centered approach reduced anxiety. Web-based multimedia decision aids created with patient input through a human-centered approach may better engage patients; address their emotions, concerns, and understanding; and promote calm deliberation.

Highlights

Conditions like chronic low back, hip, and knee pain and low-risk prostate cancer are frequently over-treated
We aimed to gain insight into whether patients who view multimedia decision aids designed with a human-centered approach about conditions such as end stage renal disease, benign prostatic hyperplasia, and early-stage invasive breast cancer understand that there is more than one way to treat their condition, if they have a better understanding the pros and cons of their treatment options, and if they have a better sense of which treatment(s) make the most sense for them
Web-based multimedia decision aids developed using a human-centered approach were prescribed to patients who needed to make a treatment decision and engage in shared decision making about chronic low back pain, chronic hip or knee pain due to OA, low-risk prostate cancer, and a variety of other conditions where shared decision making is needed

Summary

Introduction

Conditions like chronic low back, hip, and knee pain and low-risk prostate cancer are frequently over-treated. The Agency for Healthcare Research and Quality reports that for chronic low back pain, spinal fusion surgery increased from 61,000 in 1993 to 465,000 in 2011 This has not improved outcomes or reduced disability rates. Men with low-risk prostate cancer often react with fear and opt for more invasive treatments like surgery over active surveillance. These are often stressful decisions that patients do not make based solely on data and information but contain strong emotional factors as patients consider the tradeoffs and the short- and long-term effects on their lives and those of their partners and families.

Methods

Results

Conclusion