High Users of Healthcare Services: Development and Alpha Testing of a Patient Decision Aid for Case Management

Marie-Eve Poitras (), France Légaré, Vanessa Tremblay Vaillancourt, Isabelle Godbout, Annie Poirier, Karina Prévost, Claude Spence, Maud-Christine Chouinard, Hervé Tchala Vignon Zomahoun, Lobna Khadhraoui, José Massougbodji, Mathieu Bujold, Pierre Pluye and Catherine Hudon
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Marie-Eve Poitras: Université de Sherbrooke, Campus Saguenay
France Légaré: Université Laval
Vanessa Tremblay Vaillancourt: Université de Sherbrooke, Campus Saguenay
Isabelle Godbout: Université du Québec à Montréal
Annie Poirier: Université Laval
Karina Prévost: Centre Intégré Universitaire de Santé et de Services Sociaux du Saguenay-Lac-Saint-Jean
Claude Spence: Université de Sherbrooke, Campus Saguenay
Maud-Christine Chouinard: Université du Québec à Chicoutimi
Hervé Tchala Vignon Zomahoun: Université Laval
Lobna Khadhraoui: Université Laval
José Massougbodji: Université Laval
Mathieu Bujold: McGill University
Pierre Pluye: McGill University
Catherine Hudon: Université de Sherbrooke, Campus Saguenay

The Patient: Patient-Centered Outcomes Research, 2020, vol. 13, issue 6, No 12, 757-766

Abstract: Abstract Background Some patients with complex healthcare needs become high users of healthcare services. Case management allows these patients and their interprofessional team to work together to evaluate their needs, priorities and available resources. High-user patients must make an informed decision when choosing whether to engage in case management and currently there is no tool to support them. Objective The objective of this study was to develop and conduct a pilot alpha testing of a patient decision aid that supports high-user patients with complex needs and the teams who guide those patients in shared decision making when engaging in case management. Methods We chose a user-centered design to co-develop a patient decision aid with stakeholders informed by the Ottawa Research Institute and International Patient Decision Aid Standards frameworks. Perceptions and preferences for the patient decision aid’s content and format were assessed with patients and clinicians and were iteratively collected through interviews and focus groups. We developed a prototype and assessed its acceptability by using a think-aloud method and a questionnaire with three patient-partners, six clinicians and seven high-user patients with complex needs. Results The three rounds of evaluation to assess the decision aid’s acceptability highlighted comments related to simplicity, readability and visual aspect. A section presenting clinical vignettes including story telling was identified as the most helpful. Conclusions We created and evaluated a patient decision aid. Considering the positive comments, we believe that this aid has the potential to help high-user patients with complex care needs make better choices concerning case management.

Date: 2020
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DOI: 10.1007/s40271-020-00465-0

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