Pilot Testing of a Patient Decision Aid for Adolescents with Severe Obesity in US Pediatric Weight Management Programs within the COMPASS Network

Jaime Moore,Stavra Xanthakos,Ying Z Weatherall,Caren Mangarelli,Nazrat Mirza,Mary Jane Hawkins,Joan Han,Robert Siegel,Matthew Haemer

doi:10.3390/ijerph16101776

Abstract

Shared decision-making (SDM) is a best practice for delivering high-quality, patient-centered care when there are multiple options from which to choose. A patient decision aid (PDA) to promote SDM for the treatment of adolescent severe obesity was piloted among 12–17-year-olds (n = 31) from six pediatric weight management programs within the Childhood Obesity Multi Program Analysis and Study System (COMPASS). Medical providers used a brochure that described indications, risks, and benefits of intensive lifestyle management alone versus bariatric surgery plus lifestyle. Immediately after, patients/families completed a survey. Patient/family perceptions of provider effort to promote understanding of health issues, to listen to what mattered most to them, and to include what mattered most to them in choosing next steps averaged 8.6, 8.8, and 8.7, respectively (0 = no effort, 9 = every effort). Nearly all (96%) reported knowing the risks/benefits of each treatment option and feeling clear about which risks/benefits mattered most to them. Most (93%) reported having enough support/advice to make a choice, and 89% felt sure about what the best choice was. Providers largely found the PDA to be feasible and acceptable. This pilot will guide a more rigorous study to determine the PDA’s effectiveness to support decision-making for adolescent severe obesity treatment.

Highlights

The primary aim of this study was (1) to establish whether a patient decision aid (PDA) for the treatment of adolescent severe obesity was feasible and acceptable to implement within usual pediatric weight management care
We presented a pilot application of a PDA to promote Shared decision-making (SDM) for the treatment of severe obesity among adolescents across six geographically diverse pediatric weight management programs in the US
After a single use of the decision aid by the medical provider to guide a discussion of two major treatment options for severe obesity, patients/families perceived strong provider effort to embrace key principles of SDM

Summary

Introduction

Shared decision-making (SDM) is a best practice for delivering high-quality, patient-centered care when there are multiple options from which to choose. A patient decision aid (PDA) to promote. Patient/family perceptions of provider effort to promote understanding of health issues, to listen to what mattered most to them, and to include what mattered most to them in choosing steps averaged 8.6, 8.8, and 8.7, respectively Most (93%) reported having enough support/advice to make a choice, and 89% felt sure about what the best choice was. Providers largely found the PDA to be feasible and acceptable. This pilot will guide a more rigorous study to determine the PDA’s effectiveness to support decision-making for adolescent severe obesity treatment

Objectives

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Discussion

Conclusion