The Research Question:

“How do Patient Decision Aids affect patient knowledge and decisional conflict when patients and their caregivers engage in shared decision making within the childbearing year?”

 

PDA Obstetrics Full Report

PDA Obstetrics 4 page

PDAObstetrics1page

LINK TO ONLINE COMPANION DOCUMENT

Background

Research suggests that when pregnant patients and their care providers share in decision making that accounts for the patient’s personal needs and values, it can help resolve conflict and tension for both patients and their care providers. Overall, care of pregnant people is improved when clear information is presented through a balanced, comprehensive and standardized approach. One such approach to shared decision making is known as Patient Decision Aids.

Patient Decision Aids (PDA) are tools to help people make decisions, taking into account patient values and priorities alongside any clinical considerations.  They are especially useful in supporting complex decisions in cases where the scientific evidence about available options might be limited.  Some goals of Patient Decision Aids are to:

• provide unbiased, individualized information,
• provide a framework to take into account the patient’s values and preferences,
• help people to make informed choices,
• reduce anxiety around making choices,
• reduce uncertainty (or decisional conflict),
• increase knowledge about patient’s options, and
• ensure patients are satisfied with their final decision.

Importantly, Patient Decision Aids are meant to facilitate provider guidance, not to replace it, and they are not meant to persuade patients to choose one option over another.

Key Findings

The following key messages summarize the most relevant findings from this report and reflect the state of the available research evidence on this topic:

1. The research evidence suggests that Patient Decision Aids tend to improve patients’ knowledge of obstetrics topics.
2. The research evidence suggests that Patient Decision Aids tend to reduce patients’ uncertainty (decisional conflict) about the preferred course of action in pregnancy.
3. Findings about patients’ anxiety and satisfaction after using Patient Decision Aids are mixed, with some research suggesting improvements (i.e., reduced anxiety and greater satisfaction), and other research indicating no effect on these outcomes.
4. Little evidence was found for the outcome of informed decision making; however, the limited research that is available suggests that Patient Decision Aids lead to better-informed patient decisions.
5. While most of the formats of Patient Decision Aids reviewed in this report are effective, our synthesis indicates that computer-based Patient Decision Aids are the most effective.
6. Patient Decision Aids are consistently effective in most pregnancy scenarios reviewed in this report, except when used for decisions about prenatal screening.