ArticleHealth expectations : an international journal of public participation in health care and health policy2014
Barriers and facilitators to routine distribution of patient decision support interventions: a preliminary study in community-based primary care settings.
Article in Health expectations : an international journal of public participation in health care and health policy, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it.
- "Many miles to go …": a systematic review of the implementation of patient decision support interventions into routine clinical practice.BMC medical informatics and decision making · 2013Pooled it
- Implementation and sustainability factors of two early-stage breast cancer conversation aids in diverse practices.Implementation science : IS · 2021Trial
- Article
- Implementing predictive tools in surgery: A narrative review in the context of orthopaedic surgery.ANZ journal of surgery · 2022Review
- A Call for Behavioral Science in Embedded Bioethics.Perspectives in biology and medicine · 2022Article
- Development and Pilot Testing of a Patient-Centered Web-Based Reproductive Decision Support Tool for Primary Care.Journal of general internal medicine · 2021Article
- Integrating Option Grid Patient Decision Aids in the Epic Electronic Health Record: Case Study at 5 Health Systems.Journal of medical Internet research · 2021Article
- A principal components analysis of factors associated with successful implementation of an LVAD decision support tool.BMC medical informatics and decision making · 2021Article
- Differences in Implementation Outcomes of a Shared Decision-Making Program for Men with Prostate Cancer between an Academic Medical Center and County Health Care System.Medical decision making : an international journal of the Society for Medical Decision Making · 2021Article
- Development of a decision support tool in pediatric Differences/Disorders of Sex Development.Seminars in pediatric surgery · 2019Article
- Physician engagement: a concept analysis.Journal of healthcare leadership · 2019Article
- Organizational- and system-level characteristics that influence implementation of shared decision-making and strategies to address them - a scoping review.Implementation science : IS · 2018Article
- "Provoking conversations": case studies of organizations where Option Grid™ decision aids have become 'normalized'.BMC medical informatics and decision making · 2017Article
- Factors influencing implementation of a patient decision aid in a developing country: an exploratory study.Implementation science : IS · 2017Article
- Evaluation of a patient decision aid for initiating disease modifying anti-rheumatic drugs.Arthritis research & therapy · 2016Article
- Investigating the Heart Pump Implant Decision Process: Opportunities for Decision Support Tools to Help.ACM transactions on computer-human interaction : a publication of the Association for Computing Machinery · 2016Article
- Coaching patients in the use of decision and communication aids: RE-AIM evaluation of a patient support program.BMC health services research · 2015Article
- Evidence summaries (decision boxes) to prepare clinicians for shared decision-making with patients: a mixed methods implementation study.Implementation science : IS · 2014Article
- Patchy 'coherence': using normalization process theory to evaluate a multi-faceted shared decision making implementation program (MAGIC).Implementation science : IS · 2013Article
- Using Nudges to Enhance Clinicians' Implementation of Shared Decision Making With Patient Decision Aids.MDM policy & practiceArticle
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundA growing body of literature documents the value of decision support interventions (DESIs) in facilitating patient participation in preference sensitive decision making, but little is known about their implementation in routine care.
objectiveThis study explored barriers and facilitators to prescribing DESIs in primary care. SETTING AND
participantsFour community-based primary care practices across Los Angeles County serving diverse low and middle income populations participated.
designThe first phase focused on implementing DESI prescribing into routine care. Weekly academic detailing visits served to identify barriers to DESI prescribing, generate ethnographic field notes and record DESI prescriptions. The second phase explored the impact of a financial incentive on DESI prescribing. At the project's conclusion, each physician completed an in-depth interview.
resultsThe four practices prescribed an average of 6.5 DESIs a month (range 3.6-9.2) during Phase I. The financial incentive increased DESI prescribing by 71% to 11.1 per month (range 3.5-21.4). The estimated percentages of patients who viewed the DESI were 37.9 and 43.9% during Phases I and II, respectively. Qualitative data suggest that physician buy-in with the project goal was crucial to DESI distribution success. Competing demands and time pressures were persistent barriers. The effects of the financial incentive were mixed.
conclusionsThis study confirmed the importance of physician engagement when implementing DESIs and found mixed effects for providing financial incentives. The relatively low rate of DESI viewing suggests further research on increasing patient uptake of these interventions in routine practice is necessary.
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