Development and acceptability of a shared decision-making tool for commercial peanut allergy therapies.


Journal

Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology
ISSN: 1534-4436
Titre abrégé: Ann Allergy Asthma Immunol
Pays: United States
ID NLM: 9503580

Informations de publication

Date de publication:
07 2020
Historique:
received: 10 12 2019
revised: 27 01 2020
accepted: 30 01 2020
pubmed: 15 2 2020
medline: 26 9 2020
entrez: 15 2 2020
Statut: ppublish

Résumé

Shared decision making (SDM) is the process through which patients and their medical provider mutually explore therapy goals, risk/benefit, and treatment options regarding medical care. Decision aids are tools that aid in the process of values clarification and help assess decisional needs and potential decisional conflicts. To develop and assess acceptability of a decision aid for commercial peanut allergy therapies. The creation of this decision aid occurred in 3 stages, including a qualitative study to assess decisional needs, development of a draft decision aid through multiple iterations in accordance with international guidelines and decision aid experts, and assessment of decisional acceptability, decisional conflict, and decisional self-efficacy related to using the decision aid. The decision aid went through 9 iterations, resulting in a 4-page aid with 7 parts, explaining the therapies, key risks and benefits of therapy choices, relative importance of key attributes of the therapies, and a self-check assessment regarding informational adequacy and how to take the next steps. A total of 24 subjects assessed the decision aid, noting it had good acceptability, high decisional self-efficacy (mean score 91.9/100), and low decisional conflict (mean score 20.2/100). Respondents rated the information content as adequate and sufficient and the information regarding the therapy choices as fair and balanced without a clear bias or presenting a "best choice." We have developed this decision aid as a tool to help caregivers navigate the complexity of decision making for peanut allergy treatment options. The decision aid was noted to have good acceptability, with scores reflective of the instrument enhancing decisional self-efficacy and reducing decisional conflict.

Sections du résumé

BACKGROUND
Shared decision making (SDM) is the process through which patients and their medical provider mutually explore therapy goals, risk/benefit, and treatment options regarding medical care. Decision aids are tools that aid in the process of values clarification and help assess decisional needs and potential decisional conflicts.
OBJECTIVE
To develop and assess acceptability of a decision aid for commercial peanut allergy therapies.
METHODS
The creation of this decision aid occurred in 3 stages, including a qualitative study to assess decisional needs, development of a draft decision aid through multiple iterations in accordance with international guidelines and decision aid experts, and assessment of decisional acceptability, decisional conflict, and decisional self-efficacy related to using the decision aid.
RESULTS
The decision aid went through 9 iterations, resulting in a 4-page aid with 7 parts, explaining the therapies, key risks and benefits of therapy choices, relative importance of key attributes of the therapies, and a self-check assessment regarding informational adequacy and how to take the next steps. A total of 24 subjects assessed the decision aid, noting it had good acceptability, high decisional self-efficacy (mean score 91.9/100), and low decisional conflict (mean score 20.2/100). Respondents rated the information content as adequate and sufficient and the information regarding the therapy choices as fair and balanced without a clear bias or presenting a "best choice."
CONCLUSION
We have developed this decision aid as a tool to help caregivers navigate the complexity of decision making for peanut allergy treatment options. The decision aid was noted to have good acceptability, with scores reflective of the instrument enhancing decisional self-efficacy and reducing decisional conflict.

Identifiants

pubmed: 32057932
pii: S1081-1206(20)30076-4
doi: 10.1016/j.anai.2020.01.030
pii:
doi:

Types de publication

Journal Article Research Support, U.S. Gov't, P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

90-96

Subventions

Organisme : AHRQ HHS
ID : K08 HS024599
Pays : United States

Informations de copyright

Copyright © 2020. Published by Elsevier Inc.

Auteurs

Matthew Greenhawt (M)

Children's Hospital Colorado, Department of Pediatrics, Section of Allergy/Immunology, University of Colorado School of Medicine, Aurora, Colorado. Electronic address: Matthew.Greenhawt@childrenscolorado.org.

Marcus Shaker (M)

Dartmouth-Hitchcock Medical Center, Section of Allergy and Immunology, Lebanon, New Hampshire; Dartmouth Geisel School of Medicine, Hanover, New Hampshire.

Tonya Winders (T)

Allergy & Asthma Network, Vienna, Virginia.

Don A Bukstein (DA)

Allergy, Asthma & Sinus Center, Milwaukee, Greenfield, Wisconsin.

Ray S Davis (RS)

Division of Allergy Immunology & Pulmonary Medicine, Washington University School of Medicine, St. Louis, Missouri.

John Oppenheimer (J)

UMDNJ Rutgers University School of Medicine.

David M Fleischer (DM)

Children's Hospital Colorado, Department of Pediatrics, Section of Allergy/Immunology, University of Colorado School of Medicine, Aurora, Colorado.

Edwin Kim (E)

Division of Rheumatology, Allergy and Immunology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina.

Edmond S Chan (ES)

BC Children's Hospital, Division of Allergy and Immunology, Department of Pediatrics, The University of British Columbia, Vancouver, BC, Canada.

David R Stukus (DR)

Nationwide Children's Hospital, Section of Allergy and Immunology, Department of Pediatrics, The Ohio State University School of Medicine, Columbus, Ohio.

Daniel Matlock (D)

Department of Medicine, Division of Geriatric Medicine, University of Colorado School of Medicine, Aurora, Colorado; VA Eastern Colorado Geriatric Research Education and Clinical Center, Denver, Colorado.

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