Designing DECIdE Together: An Interprofessional and Patient-Centered Approach to Develop a Patient Decision Aid for...

Background. In primary care, general practitioners (GPs) and community pharmacists (CPs) play pivotal roles in guiding patients' drug choices. Nonprescription drugs (NPDs), which are dispensed with or without a prescription, represent significant health care costs. NPDs are most often used for symptomatic relief and may be subject to shared decision making. We designed shared DECIsion in hEalth (DECIdE), a patient decision aid for NPDs in primary care, via a 3-step user-centered approach. Design. In the first step, a nominal group composed of potential future users (patients, GPs, and CPs) reached a consensus on the prototype's specifications. In the second step, GPs, CPs, and their patients tested the prototype in user tests during simulated consultations based on real-life scenarios, and clinical psychologists conducted individual interviews to improve the prototype. In the third step, international experts used the eDELPHI consensus method to validate DECIdE as a shared decision aid. Results. Sixteen participants in the nominal group reached a consensus on 18 specifications. The user tests involved 16 patients and 4 health care professionals across 2 cycles. The prototypes were improved according to an analysis of 20 individual interviews. Fifteen French-speaking experts, searchers, physicians, and pharmacists from 4 countries reached a consensus on 11 of the 13 propositions inspired by the IPDAS criteria and the French HAS criteria in 2 rounds to validate the final prototype of DECIdE. Conclusion. Interprofessional collaboration at each step of development is the main strength of this user-centered design. DECIdE is currently being evaluated for its effects on decisional conflict in GPs' practices and community pharmacies in a randomized controlled trial. Implications. DECIdE could encourage more rational use of NPDs, particularly in self-medication.

DECIdE is the first patient decision aid in French for usual drugs in primary care, based on the latest scientific data in line with an evidence-based medicine approach for general practitioners (GPs) and community pharmacists (CPs).DECIdE's user-centered design includes interprofessional collaboration at each step between searchers, GPs, CPs, and social and clinical psychologists.The original 3 steps of the user-centered design of DECIdE combined user testing with qualitative analysis and 2 successive consensus methods to create and validate the patient decision aid using the nominal group and eDELPHI methods.The free availability of DECIdE on a dedicated Web site will enable GPs and CPs to make widespread use of shared decisions about nonprescription drugs daily.