Using patient decision aids in the consultation

A few months ago I asked Jon Brassey of Tripdatabase, a clinical search engine or metasearch, if he could ask patient decision aids to the database. Patient decision aids (PDAs) are tools that are made with the aim of helping patients make decisions about treatment options through considering the risks and benefits of options. They are produced by the UK National Prescribing Centre (NPC) and NHS Direct, amongst others. The advantage of having them listed in a metasearch is that I don't have to go round several sites checking if they might have a decision aid on the topic I am interested in.

Tripdatabase is a small but dynamic organisation and it makes great use of social media. Jon uses a Facebook page to get feedback from users, and I was able to give him my suggestion my sending him a tweet. You can see how quickly he responded here, but the short version is that in less than 3 weeks PDAs were added to Trip!

I've recorded the following screencast to show how I used Tripdatabase to share decison making with a patient. In this case the decision to start warfarin to reduce the risks of stroke in atrial fibrillation had been made in secondary care but we were able to review the evidence for this together. We also used the NPC patient decision aid to review the risks and benefits of warfarin treatment.



As you can see the NPC decision aid is not perfect. I don't think that a PDF is the ideal format for exploring this information online. And I don't have access to a colour printer in the surgery so if printing it might be good to have the option to print a version that was not so dependent on colour graphics.

Have you any thoughts on how PDAs can be incorporated into consultations? Please leave a comment!

EDIT 7/2/2012 As I mention in the audio here I explicitly asked this patient's consent to share this story.

EDIT 7/12/2015 Key learning for me in this was that the patient had different concerns to that which I assumed they had. I thought they were worried about inconvenience of warfarin (for given benefit), but they were actually concerned about risk of harm. The decision aid reassured them about risk of harm.

On being public : How social media reshapes professional identity.

This was my presentation at ALT-C (conference of the Association for Learning Technology) earlier this year. It sums up in 20 minutes a lot of the thoughts and ideas that are covered in this blog. But of course it raises more questions than answers- I hope!