Exploring Provider Reactions to Decision Aid Distribution and Shared Decision Making: Lessons from Two Specialties

Area of Science:

• Health Services Research
• Medical Decision Making
• Qualitative Health Research

Background:

• Shared decision making (SDM) relies on healthcare providers distributing decision aids (DAs).
• Provider perspectives are vital for DA design and implementation, yet differences across specialties remain understudied.
• This study investigated provider attitudes towards DAs and SDM in two specialties during an implementation project.

Purpose of the Study:

• To explore how provider attitudes across specialties influence the implementation of DAs and SDM.
• To examine shifts in provider attitudes towards DAs and SDM over time.
• To identify factors influencing the successful integration of DAs into clinical practice.

Main Methods:

• Qualitative interviews were conducted with specialty care providers (orthopedics and cardiology).
• Interviews were conducted at two time points during the Decision Aid Implementation project.
• Thematic analysis was used to analyze interview data from 19 providers.

Main Results:

• Providers universally valued patient information and active roles in decision-making.
• Significant divergence in decision-making styles and views on DA/SDM practicality and appropriateness was observed.
• Cardiology specialists expressed ambivalence towards DAs for specific conditions, deeming them unnecessary or inappropriate.
• Provider attitudes towards DAs and SDM remained largely stable over the two-year study period.

Conclusions:

• Successful DA implementation for SDM necessitates addressing specialty-specific provider attitudes, beliefs, and knowledge.
• Engaging providers for input during DA development and implementation is essential.
• Tailoring DA and SDM approaches to specific clinical conditions and care processes is recommended.