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Patient Educ Couns. 2012 Jun;87(3):360-8. doi: 10.1016/j.pec.2011.10.009. Epub 2011 Dec 10.

Effectiveness of a web-based, individually tailored decision aid for depression or acute low back pain: a randomized controlled trial.

Author information

1
University Medical Center Freiburg, Department of Psychiatry and Psychotherapy, Freiburg, Germany.

Abstract

OBJECTIVE:

To evaluate the effectiveness of a web-based, individually tailored decision aid (Patient Dialogue) on depression or acute low back pain for insurees of a German sickness fund.

METHODS:

Patient Dialogue (PD) was compared to the non-tailored Static Patient Information (SPI) in an online randomized controlled trial (RCT). The primary outcome was decisional conflict; secondary outcomes included knowledge, preparation for decision-making, preference for participation, involvement in decision-making, decision regret, and adherence.

RESULTS:

Out of 2480 randomized participants, 657 (26.5%) provided analyzable data immediately after using the system. Three months later, data from 131 (5.3%) participants could be included in the analysis. The PD group reported a significantly lower overall decisional conflict than the SPI group (38.7 vs. 45.1; p=0.028 via multiple imputation estimator). The largest standardized effect (Cohen's d 0.56) resulted from the preparation for decision-making (PD 59.4 vs. SPI 46.8; p<0.001).

CONCLUSION:

PD may be an effective tool to reduce decisional conflict and prepare participants for treatment decision-making. However, the large dropout rate needs to be taken into account.

PRACTICE IMPLICATIONS:

This study shows how a health insurance fund can support shared decision-making and how a decision aid can be evaluated in a RCT under routine care conditions.

PMID:
22154867
DOI:
10.1016/j.pec.2011.10.009
[Indexed for MEDLINE]

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