Guidance and/or Decision Coaching with Patient Decision Aids: Scoping Reviews to Inform the International Patient Decision Aid Standards (IPDAS)

Anne Christin Rahn, Janet Jull, Laura Boland, Jeanette Finderup, Marie-Chantal Loiselle, Maureen Smith, Sascha Köpke and Dawn Stacey
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Anne Christin Rahn: Institute for Social Medicine and Epidemiology, Nursing Research Unit, University of Lübeck, Lübeck, Germany, Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Janet Jull: Queen’s University, Kingston, ON, Canada
Laura Boland: Western University, London, Canada
Jeanette Finderup: Aarhus University Hospital & Aarhus University, Aarhus, Denmark and ResCenPI - Research Centre for Patient Involvement, Aarhus University & the Central Denmark Region, Denmark
Marie-Chantal Loiselle: University of Sherbrooke, Longueuil, Quebec, Canada
Maureen Smith: Cochrane Consumer, Ottawa, ON, Canada
Sascha Köpke: Institute of Nursing Science, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
Dawn Stacey: University of Ottawa and Ottawa Hospital Research Institute, Ottawa, ON, Canada

Medical Decision Making, 2021, vol. 41, issue 7, 938-953

Abstract: Introduction In 2005, the International Patient Decision Aid Standards (IPDAS) collaboration identified guidance and decision coaching as important dimensions of patient decision aids (PtDAs) and developed a set of quality criteria. We sought to update definitions, theoretical rationale, and evidence for guidance and/or decision coaching used within or alongside PtDAs for the IPDAS update 2.0. Methods We conducted 2 scoping reviews on guidance and decision coaching, including systematic searches and a hand search of the Cochrane Review on PtDAs. Eligible studies were randomized controlled trials (RCTs) on guidance or decision coaching used with/alongside PtDAs. Data, including conceptual models, were summarized narratively and with meta-analyses when appropriate. Results Of 1022 citations, we found no RCTs that evaluated guidance in PtDAs. The 2013 definition for guidance was endorsed, and we made minimal changes to the description of guidance. Of 3039 citations, we identified 21 RCTs on decision coaching informed by 5 conceptual models stating that people exposed to decision coaching are more likely to progress in making informed decisions consistent with their values. Compared to usual care, decision coaching with PtDAs led to improved knowledge mean difference [MD], 19.5/100; 95% confidence interval [CI], 10.0–29.0; 5 RCTs). Compared to decision coaching alone, PtDAs led to a small improvement in knowledge (MD, 3.6/100; 95% CI, 1.0–6.3; 3 RCTs). There were variable effects on other outcomes. We simplified the decision coaching definition slightly and defined minimal decision coaching elements. Conclusion We found no evidence on which to propose changes in guidance in IPDAS. Decision coaching is continuing to be used alongside PtDAs, but there is inadequate evidence on the added effectiveness compared to PtDAs alone. The decision coaching definition was updated with minimal elements.

Keywords: guidance; decision coaching; patient decision aid; decision making; randomized controlled trials; conceptual models; shared decision making (search for similar items in EconPapers)
Date: 2021
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:41:y:2021:i:7:p:938-953

DOI: 10.1177/0272989X21997330

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