Randomized Trial of the Choosing Wisely Consumer Questions and a Shared Decision-Making Video Intervention on Decision-Making Outcomes.

Adult Humans Decision Making, Shared Health Literacy Patient Participation Australia Intention Decision Making
decision making health literacy low-value care patient participation question prompt list, medical overuse 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:
08 2023
Historique:
medline: 14 8 2023
pubmed: 5 7 2023
entrez: 5 7 2023
Statut: ppublish

Résumé

Despite widespread use, there are few studies evaluating the consumer Choosing Wisely questions. We evaluated the impact of the Choosing Wisely questions on consumers' decision-making outcomes. Adults living in Australia were presented with a hypothetical low-value care scenario. Using a 2×2×2 between-subjects factorial design, they were randomized to either the Choosing Wisely questions ("Questions"), a shared decision-making (SDM) preparation video ("Video"), both interventions, or control (no intervention). Primary outcomes were 1) self-efficacy to ask questions and be involved in decision-making and 2) intention to engage in SDM. A total of 1,439 participants (45.6% with "inadequate" health literacy) were eligible and included in the analysis. Intention to engage in SDM was higher in people randomized to the Video (mean difference [MD] = 0.24 [scale 0-6], 95% confidence interval [CI]: 0.14, 0.35), Questions (MD = 0.12, 95% CI: 0.01, 0.22), and both interventions (MD = 0.33, 95% CI: 0.23-0.44, The Choosing Wisely questions and a video to promote SDM may improve intention to engage in SDM and support patients in identifying questions that align with the Choosing Wisely campaign (with some additional benefits of the video intervention). ANZCTR376477. We conducted a randomized controlled trial online with adults living in Australia to test the effectiveness of the consumer Choosing Wisely questions and a shared decision-making (SDM) preparation video.Both interventions improved intention to engage in SDM and supported participants to identify questions that align with the Choosing Wisely campaign.There were some additional benefits of the Video intervention in reducing willingness to accept low-value treatment for low-back pain without asking questions; however, neither intervention changed participants' self-efficacy to ask questions and be involved in decision-making nor affected perceptions of preparedness to engage in SDM or knowledge of rights to be involved in health care decision-making.The simple, low-cost nature of the interventions may make them appropriate for implementation within a suite of approaches to address low-value care at a population level.

Sections du résumé

BACKGROUND
Despite widespread use, there are few studies evaluating the consumer Choosing Wisely questions.
METHODS
We evaluated the impact of the Choosing Wisely questions on consumers' decision-making outcomes. Adults living in Australia were presented with a hypothetical low-value care scenario. Using a 2×2×2 between-subjects factorial design, they were randomized to either the Choosing Wisely questions ("Questions"), a shared decision-making (SDM) preparation video ("Video"), both interventions, or control (no intervention). Primary outcomes were 1) self-efficacy to ask questions and be involved in decision-making and 2) intention to engage in SDM.
RESULTS
A total of 1,439 participants (45.6% with "inadequate" health literacy) were eligible and included in the analysis. Intention to engage in SDM was higher in people randomized to the Video (mean difference [MD] = 0.24 [scale 0-6], 95% confidence interval [CI]: 0.14, 0.35), Questions (MD = 0.12, 95% CI: 0.01, 0.22), and both interventions (MD = 0.33, 95% CI: 0.23-0.44,
CONCLUSIONS
The Choosing Wisely questions and a video to promote SDM may improve intention to engage in SDM and support patients in identifying questions that align with the Choosing Wisely campaign (with some additional benefits of the video intervention).
TRIAL REGISTRATION
ANZCTR376477.
HIGHLIGHTS
We conducted a randomized controlled trial online with adults living in Australia to test the effectiveness of the consumer Choosing Wisely questions and a shared decision-making (SDM) preparation video.Both interventions improved intention to engage in SDM and supported participants to identify questions that align with the Choosing Wisely campaign.There were some additional benefits of the Video intervention in reducing willingness to accept low-value treatment for low-back pain without asking questions; however, neither intervention changed participants' self-efficacy to ask questions and be involved in decision-making nor affected perceptions of preparedness to engage in SDM or knowledge of rights to be involved in health care decision-making.The simple, low-cost nature of the interventions may make them appropriate for implementation within a suite of approaches to address low-value care at a population level.

Identifiants

DOI: 10.1177/0272989X231184461 PMID: 37403779 PMC: PMC10422858
pubmed: 37403779
doi: 10.1177/0272989X231184461
pmc: PMC10422858
doi:

Types de publication

Randomized Controlled Trial Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

642-655

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Auteurs

Danielle Marie Muscat (DM)

Faculty of Medicine and Health, School of Public Health, Sydney Health Literacy Lab, University of Sydney, New South Wales, Australia.
Faculty of Medicine and Health, School of Public Health, Wiser Healthcare, University of Sydney, New South Wales, Australia.

Rachel Thompson (R)

Faculty of Medicine and Health, School of Public Health, Sydney Health Literacy Lab, University of Sydney, New South Wales, Australia.
Faculty of Medicine and Health, School of Public Health, Wiser Healthcare, University of Sydney, New South Wales, Australia.
Faculty of Medicine and Health, School of Health Sciences, University of Sydney, New South Wales, Australia.
ORCID: 0000-0002-1009-0746

Erin Cvejic (E)

Faculty of Medicine and Health, School of Public Health, Sydney Health Literacy Lab, University of Sydney, New South Wales, Australia.
Faculty of Medicine and Health, School of Public Health, University of Sydney, New South Wales, Australia.

Jenna Smith (J)

Faculty of Medicine and Health, School of Public Health, Sydney Health Literacy Lab, University of Sydney, New South Wales, Australia.
Faculty of Medicine and Health, School of Public Health, Wiser Healthcare, University of Sydney, New South Wales, Australia.
ORCID: 0000-0002-0480-8125

Edward Hoi-Fan Chang (EH)

Faculty of Medicine and Health, School of Public Health, Sydney Health Literacy Lab, University of Sydney, New South Wales, Australia.

Marguerite Tracy (M)

Faculty of Medicine and Health, School of Public Health, Sydney Health Literacy Lab, University of Sydney, New South Wales, Australia.
ORCID: 0000-0003-1247-6412

Joshua Zadro (J)

Faculty of Medicine and Health, School of Public Health, Institute for Musculoskeletal Health, University of Sydney, New South Wales, Australia.
ORCID: 0000-0001-8981-2125

Robyn Lindner (R)

NPS Medicinewise, New South Wales, Australia.

Kirsten J McCaffery (KJ)

Faculty of Medicine and Health, School of Public Health, Sydney Health Literacy Lab, University of Sydney, New South Wales, Australia.
Faculty of Medicine and Health, School of Public Health, Wiser Healthcare, University of Sydney, New South Wales, Australia.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Randomized Trial of the Choosing Wisely...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Randomized Trial of the Choosing Wisely...
questionsmedicales.fr › Activités humaines › Participation des parties prenantes › Prise de décision partagée › Randomized Trial of the Choosing Wisely...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Services de santé › Services de médecine préventive › Éducation pour la santé › Information en santé des consommateurs › Compétence informationnelle en santé › Randomized Trial of the Choosing Wisely...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Prestations des soins de santé › Attitude envers la santé › Adhésion et observance thérapeutiques › Acceptation des soins par les patients › Participation des patients › Randomized Trial of the Choosing Wisely...
questionsmedicales.fr › Régions géographiques › Océanie › Australasie › Australie › Randomized Trial of the Choosing Wisely...
questionsmedicales.fr › Phénomènes psychologiques › Processus mentaux › Intention › Randomized Trial of the Choosing Wisely...
questionsmedicales.fr › Phénomènes psychologiques › Processus mentaux › Pensée (activité mentale) › Prise de décision › Randomized Trial of the Choosing Wisely...