Work

Designing DECIdE Together: An Interprofessional and Patient-Centered Approach to Develop a Patient Decision Aid for Drugs in Primary Care (DECIsion in hEalth)

Year: 2025

Type: article

Abstract: Background. In primary care, general practitioners (GPs) and community pharmacists (CPs) play pivotal roles in guiding patients’ drug choices. Nonprescription drugs (NPDs), which are dispensed with or without a prescription, represent significant health care costs. NPDs are most often used for symptomatic relief and may be subject to shared decision making. We designed shared DECIsion in hEalth (DECIdE), a patient decision aid for NPDs in primary care, via a 3-step user-centered approach. Design. In the first step, a nominal group composed of potential future users (patients, GPs, and CPs) reached a consensus on the prototype’s specifications. In the second step, GPs, CPs, and their patients tested the prototype in user tests during simulated consultations based on real-life scenarios, and clinical psychologists conducted individual interviews to improve the prototype. In the third step, international experts used the eDELPHI consensus method to validate DECIdE as a shared decision aid. Results. Sixteen participants in the nominal group reached a consensus on 18 specifications. The user tests involved 16 patients and 4 health care professionals across 2 cycles. The prototypes were improved according to an analysis of 20 individual interviews. Fifteen French-speaking experts, searchers, physicians, and pharmacists from 4 countries reached a consensus on 11 of the 13 propositions inspired by the IPDAS criteria and the French HAS criteria in 2 rounds to validate the final prototype of DECIdE. Conclusion . Interprofessional collaboration at each step of development is the main strength of this user-centered design. DECIdE is currently being evaluated for its effects on decisional conflict in GPs’ practices and community pharmacies in a randomized controlled trial. Implications. DECIdE could encourage more rational use of NPDs, particularly in self-medication. Highlights DECIdE is the first patient decision aid in French for usual drugs in primary care, based on the latest scientific data in line with an evidence-based medicine approach for general practitioners (GPs) and community pharmacists (CPs). DECIdE’s user-centered design includes interprofessional collaboration at each step between searchers, GPs, CPs, and social and clinical psychologists. The original 3 steps of the user-centered design of DECIdE combined user testing with qualitative analysis and 2 successive consensus methods to create and validate the patient decision aid using the nominal group and eDELPHI methods. The free availability of DECIdE on a dedicated Web site will enable GPs and CPs to make widespread use of shared decisions about nonprescription drugs daily.

Source: MDM Policy & Practice

DOI: 10.1177/23814683251382260