Randomized Trial of the Choosing Wisely Consumer Questions and a Shared Decision-Making Video Intervention on Decision-Making Outcomes

Danielle Marie Muscat, Rachel Thompson, Erin Cvejic, Jenna Smith, Edward Hoi-fan Chang, Marguerite Tracy, Joshua Zadro, Robyn Lindner and Kirsten J. McCaffery
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Danielle Marie Muscat: Faculty of Medicine and Health, School of Public Health, Sydney Health Literacy Lab, University of Sydney, New South Wales, Australia
Rachel Thompson: Faculty of Medicine and Health, School of Public Health, Sydney Health Literacy Lab, University of Sydney, New South Wales, Australia
Erin Cvejic: Faculty of Medicine and Health, School of Public Health, Sydney Health Literacy Lab, University of Sydney, New South Wales, Australia
Jenna Smith: Faculty of Medicine and Health, School of Public Health, Sydney Health Literacy Lab, University of Sydney, New South Wales, Australia
Edward Hoi-fan Chang: Faculty of Medicine and Health, School of Public Health, Sydney Health Literacy Lab, University of Sydney, New South Wales, Australia
Marguerite Tracy: Faculty of Medicine and Health, School of Public Health, Sydney Health Literacy Lab, University of Sydney, New South Wales, Australia
Joshua Zadro: Faculty of Medicine and Health, School of Public Health, Institute for Musculoskeletal Health, University of Sydney, New South Wales, Australia
Robyn Lindner: NPS Medicinewise, New South Wales, Australia
Kirsten J. McCaffery: Faculty of Medicine and Health, School of Public Health, Sydney Health Literacy Lab, University of Sydney, New South Wales, Australia

Medical Decision Making, 2023, vol. 43, issue 6, 642-655

Abstract: Background Despite widespread use, there are few studies evaluating the consumer Choosing Wisely questions. Methods We evaluated the impact of the Choosing Wisely questions on consumers’ decision-making outcomes. Adults living in Australia were presented with a hypothetical low-value care scenario. Using a 2×2×2 between-subjects factorial design, they were randomized to either the Choosing Wisely questions (“Questions†), a shared decision-making (SDM) preparation video (“Video†), both interventions, or control (no intervention). Primary outcomes were 1) self-efficacy to ask questions and be involved in decision-making and 2) intention to engage in SDM. Results A total of 1,439 participants (45.6% with “inadequate†health literacy) were eligible and included in the analysis. Intention to engage in SDM was higher in people randomized to the Video (mean difference [MD] = 0.24 [scale 0–6], 95% confidence interval [CI]: 0.14, 0.35), Questions (MD = 0.12, 95% CI: 0.01, 0.22), and both interventions (MD = 0.33, 95% CI: 0.23–0.44, P   80%), but proactive access was low (1.7%–20.8%). Compared with control, participants who received one or both interventions asked more questions that mapped to the Choosing Wisely questions (all P  

Keywords: shared decision making; health literacy; question prompt list, medical overuse; low-value care; patient participation; decision making (search for similar items in EconPapers)
Date: 2023
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:43:y:2023:i:6:p:642-655

DOI: 10.1177/0272989X231184461

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