Abstract
BackgroundPatient preference is one of the main components of clinical decision making, therefore leading to the development of patient decision aids. The goal of this study was to describe physicians’ and patients’ viewpoints on the barriers and limitations of using patient decision aids in Iran, their proposed solutions, and, the benefits of using these tools.MethodsThis qualitative study was conducted in 2011 in Iran by holding in-depth interviews with 14 physicians and 8 arthritis patient. Interviewees were selected through purposeful and maximum variation sampling. As an example, a patient decision aid on the treatment of knee arthritis was developed upon literature reviews and gathering expert opinion, and was presented at the time of interview. Thematic analysis was conducted to analyze the data by using the OpenCode software.ResultsThe results were summarized into three categories and ten codes. The extracted categories were the perceived benefits of using the tools, as well as the patient-related and physician-related barriers in using decision aids. The following barriers in using patient decision aids were identified in this study: lack of patients and physicians’ trainings in shared decision making, lack of specialist per capita, low treatment tariffs and lack of an exact evaluation system for patient participation in decision making.ConclusionsNo doubt these barriers demand the health authorities’ special attention. Hence, despite patients and physicians’ inclination toward using patient decision aids, these problems have hindered the practical usage of these tools in Iran - as a developing country.
Highlights
Patient preference is one of the main components of clinical decision making, leading to the development of patient decision aids
Two of the men and 3 women were selected from public hospitals and were of lower socio-economic status (LSES)
The remaining participants were of upper socio-economic status (USES)
Summary
Patient preference is one of the main components of clinical decision making, leading to the development of patient decision aids. Which include most decisions, there is no definite evidence about the balance between their benefits and harms In these cases, choosing the right treatment according to the patients’ conditions is difficult. They need to be involved in the decision making process. Patient value is one of the main principles of evidence-based medicine and clinical decision making. PDAs have been provided in different forms of media such as decision boards, video CDs, audio tapes, e-books, pamphlets, and group presentations They have made the existing evidence on treatment benefits and harms easier for patients to understand [3,4,5,6,7]. This tool helps the patient select a treatment to his/her own benefit, based on his/her own values [7]
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