Decision aids help patients choose best treatment options

August 30, 2001

Randomised controlled trial of an interactive multimedia decision aid on hormone replacement therapy in primary care BMJ Volume 323, pp 490-3

Randomised controlled trial of an interactive multimedia decision aid on benign prostatic hypertrophy in primary care BMJ Volume 323, pp 493-6

Editorial: A key medical decision maker: the patient BMJ Volume 323, pp 466-7

Interactive decision aids improves patient knowledge and can help patients play a more active part in making decisions about their treatment, suggest two studies in this week's BMJ.

In the first study, 205 women in the UK considering hormone replacement treatment were randomly given either normal clinical care or a computer-based interactive decision aid by their general practitioners. The decision aid was acceptable to both the patients and their general practitioners. It enhanced the women's understanding of the effects of hormone replacement therapy and seemed to reduce decisional conflict. Patients who viewed the programme played a more active part in the decision making process and were no more anxious than those who received normal care.

In the second study, much the same conclusions were drawn about a decision aid for men considering treatment for prostate problems. Such aids could be introduced throughout the NHS at relatively low cost by using the internet, conclude the authors.

Nevertheless, many questions remain, writes Professor Richard Deyo in an accompanying editorial. For example, how can we ensure that presentations are objective and balanced, rather than designed to lead patients to a particular conclusion? How will programmes be continuously updated, and who will support this work?

If such questions can be addressed we might expect to have better informed patients, a more meaningful consent process, and more consistent practice patterns, he concludes.


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