Impact on Decisional Quality With Implementation of a Shared Decision Aid for Contraceptive Choice [2F

Abstract

INTRODUCTION: The best contraceptive choice for a woman is one that takes into consideration their personal preferences and contraceptive needs. Shared decision aids have helped patients to identify the choice that likely best matches their needs. METHODS: A quality improvement project is being conducted at University of California Los Angeles. Patients were sent a web-based educational decision aid via an online patient portal prior to their appointment. We compared their decision quality, level of familiarity with various contraceptive options, satisfaction with decision, decisional conflict, shared decision making, health literacy and patient experience with a group of patients that did not receive the decision aid. RESULTS: A higher proportion of women that received the decision aid were interested in highly effective contraceptives such as intrauterine devices (20% versus 10%, p=0.0849) and a lower proportion were interested in less effective methods such as condoms (7% versus 23%, p=0.0055) compared to women not receiving the decision aid. Participants with low decisional quality (SURE=0-3) reported more decisional conflict than those with high decisional quality (SURE=4), regardless of whether or not they received the educational content (1.67 vs 1.23, p=0.0079; 1.88 vs 1.23, p=0.0002, respectively). CONCLUSION: Patient education aids offer patients information about contraceptive options, which may impact their contraceptive preferences. The quality improvement project is ongoing and we will collect more data to assess the effect of shared decision aid on the decisional quality and conflict. We plan to perform qualitative studies to further understand the factors affecting decisional quality.