A Systematic Review and Meta-Analysis of Patient Decision Aids for Socially Disadvantaged Populations: Update from the International Patient Decision Aid Standards (IDPAS).
health disparities
health literacy
patient decision aids
patient-provider communication
shared decision making
Journal
Medical decision making : an international journal of the Society for Medical Decision Making
ISSN: 1552-681X
Titre abrégé: Med Decis Making
Pays: United States
ID NLM: 8109073
Informations de publication
Date de publication:
10 2021
10 2021
Historique:
pubmed:
22
6
2021
medline:
26
11
2021
entrez:
21
6
2021
Statut:
ppublish
Résumé
The effectiveness of patient decision aids (PtDAs) and other shared decision-making (SDM) interventions for socially disadvantaged populations has not been well studied. To assess whether PtDAs and other SDM interventions improve outcomes or decrease health inequalities among socially disadvantaged populations and determine the critical features of successful interventions. MEDLINE, CINAHL, Cochrane, PsycINFO, and Web of Science from inception to October 2019. Cochrane systematic reviews on PtDAs. Randomized controlled trials of PtDAs and SDM interventions that included socially disadvantaged populations. Independent double data extraction using a standardized form and the Template for Intervention Description and Replication checklist. Twenty-five PtDA and 13 other SDM intervention trials met our inclusion criteria. Compared with usual care, PtDAs improved knowledge (mean difference = 13.91, 95% confidence interval [CI] 9.01, 18.82 [I Sixteen PtDA studies had an overall unclear risk of bias. Heterogeneity was high for most outcomes. Most studies only had short-term follow-up. PtDAs led to better outcomes among socially disadvantaged populations but did not reduce health inequalities. We could not determine which intervention features were most effective.[Box: see text].
Sections du résumé
BACKGROUND
The effectiveness of patient decision aids (PtDAs) and other shared decision-making (SDM) interventions for socially disadvantaged populations has not been well studied.
PURPOSE
To assess whether PtDAs and other SDM interventions improve outcomes or decrease health inequalities among socially disadvantaged populations and determine the critical features of successful interventions.
DATA SOURCES
MEDLINE, CINAHL, Cochrane, PsycINFO, and Web of Science from inception to October 2019. Cochrane systematic reviews on PtDAs.
STUDY SELECTION
Randomized controlled trials of PtDAs and SDM interventions that included socially disadvantaged populations.
DATA EXTRACTION
Independent double data extraction using a standardized form and the Template for Intervention Description and Replication checklist.
DATA SYNTHESIS
Twenty-five PtDA and 13 other SDM intervention trials met our inclusion criteria. Compared with usual care, PtDAs improved knowledge (mean difference = 13.91, 95% confidence interval [CI] 9.01, 18.82 [I
LIMITATIONS
Sixteen PtDA studies had an overall unclear risk of bias. Heterogeneity was high for most outcomes. Most studies only had short-term follow-up.
CONCLUSIONS
PtDAs led to better outcomes among socially disadvantaged populations but did not reduce health inequalities. We could not determine which intervention features were most effective.[Box: see text].
Identifiants
pubmed: 34151614
doi: 10.1177/0272989X211020317
pmc: PMC8763253
mid: NIHMS1751421
doi:
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
870-896Subventions
Organisme : NIA NIH HHS
ID : K23 AG062795
Pays : United States
Organisme : NCI NIH HHS
ID : P30 CA023108
Pays : United States
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