Patients’ views on using decision support tools: a systematic review

Abstract

Background, aims and scope: Decision support tools assist patients in medical decision-making. However, implementing these tools in practice is challenging. We systematically reviewed barriers and facilitators to using decision support tools, as perceived by patients. Methods: A systematic search of scientific articles was performed in MEDLINE, CENTRAL, EMBASE and CINHAL databases. Search strategies combined pre-defined free-text words and MeSH, or database equivalent, derived from the following broad topic areas: decision support tools, barriers and facilitators, use or implementation and user perceptions. Eligible studies qualitatively presented patients’ views on using tools. These views were thematically analyzed, starting from an existing taxonomy of barriers to and facilitators of the implementation of healthcare innovations. Results: Electronic searches yielded a total of 7067 unique references; 365 full-text articles were retrieved, of which 33 publications met the inclusion criteria. Seven additional publications were included after reference searching. Key descriptive themes were classified in three broad categories of tool-, user- and environment-related barriers and facilitators. The most commonly identified themes were perceived usefulness, ease of use, the health professional-patient relationship, quality and quantity of information and need as motivation to use tools.Conclusions: Patients express a need for decision support, but experience obstacles to using tools. The two most common, attitude-related, barriers to tool use were the perceived difficulty of using a tool and its dubious efficacy. The results of this review can support researchers in the design of development and evaluation strategies that specifically address the identified barriers and facilitators and thus further the implementation of decision support tools.