Exploring the preferences of involved health professionals regarding the implementation of an online decision aid to support couples during reproductive decision-making in hereditary cancer: a mixed methods approach

Kelly Reumkens,Christine E M De Die-Smulders,Liesbeth A D M Van Osch

doi:10.1007/s10689-019-00119-7

Kelly Reumkens, Christine E M De Die-Smulders + Show 1 more

Open Access

https://doi.org/10.1007/s10689-019-00119-7

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Journal: Familial cancer	Publication Date: Jan 17, 2019
Citations: 3	License type: open-access

Affiliation: Maastricht University Medical Centre

Abstract

To support persons having a genetic predisposition to cancer and their partners during reproductive decision-making, an online decision aid was developed and evaluated. To maximize the impact of the support tool, this mixed methods study aims at developing the optimal implementation strategy for the decision aid. A questionnaire to assess the critical determinants that may affect this implementation was completed by health professionals involved in oncogenetic counselling (N = 46). Subsequently, semi-structured focus groups (N = 19) and individual telephonic interviews (N = 15) were performed with a subset of health professionals. All health professionals indicated to be willing to refer couples to the decision aid, preferably at the moment of receiving the genetic test result. They agreed that the primary requirement for implementation in daily practice was ease of referring couples and preferably free online accessibility. Referral to the tool was able to be included in the standard report couples receive after consultation, thereby making the use of additional paper-based materials redundant (e.g. flyers). Furthermore, incorporating the link to the decision aid on patient organization websites was suggested. Health professionals agreed that implementation would benefit more from promoting awareness regarding the decision aid rather than the inclusion of the tool in official clinical guidelines. To foster implementation of the decision aid, the distribution of online newsletters and the designation of a contact person charged with continued implementation in each Clinical Genetic Center were suggested. Based on these preferences and recommendations, the implementation of the online decision aid will be nationally executed to optimize impact.

Highlights

In recent decades, an increasing number of evidence-based patient decision aids have been developed to assist patients in the decision-making process of medical decisions
This study aims at developing the optimal implementation strategy for the decision aid by investigating the preferences of health professionals involved in oncogenetic consultations in the Netherlands
Health professionals agreed that keeping referral of couples to the decision aid easy to apply within daily practice, was the primary requirement for implementation of the decision aid

Summary

Introduction

An increasing number of evidence-based patient decision aids have been developed to assist patients in the decision-making process of (complex) medical decisions. They have been proven effective in improving decision quality while enhancing, not replacing, the traditional process of patient counselling by practitioners [1]. To optimize the impact of patient decision aids, it is of great importance to focus on the active implementation after proven effectiveness [4, 5]. The implementation phase is considered to be a complex process, it is important to optimize this process of providing eligible patients with the tool to optimize the overall reach

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