Strumenti decisionali

When helping patients make decisions about their health, there may be many different treatment options, each with different outcomes. Decision aids are designed to provide concise and evidenced-based information to help decide between different options.

Many of these decision aids were initially developed by the MAGIC ('making good decisions in collaboration) project. It looked at how to embed best practice in shared decision making.

Decision aids have great potential for improving individuals' healthcare experiences, such as helping patients feel involved and listened to, and giving them a say in what happens to them. Getting patients engaged can bring added benefits. It is claimed that, when patients are engaged and follow their treatment plans, their health outcomes improve and resources tend to be used more effectively. NHS England now provides a number of decision support tools (see reference link for those currently available).¹

Decision aids can be a valuable tool for shared medical decision making. Their quality and usefulness can be maximised by involving users in their creation and by attending to key considerations in their design (particularly avoiding format bias), implementation, and appraisal.²

A Cochrane review concluded that:³

• People exposed to decision aids feel more knowledgeable, better informed, and clearer about their values, and they probably have a more active role in decision making and more accurate risk perceptions.

• Further research is needed on the effects on adherence with the chosen option, cost-effectiveness, and use with lower literacy populations.

A further review found that decision aids improve older adults' knowledge, increase their risk perception, decrease decisional conflict and seem to enhance participation in shared decision making.⁴

However other research has shown only some positive behavioural effects of decision aids with variable results and outcomes.⁵