High Users of Healthcare Services: Development and Alpha Testing of a Patient Decision Aid for Case Management
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ORIGINAL RESEARCH ARTICLE
High Users of Healthcare Services: Development and Alpha Testing of a Patient Decision Aid for Case Management Marie‑Eve Poitras1,2,3 · France Légaré4,5 · Vanessa Tremblay Vaillancourt1,2,3 · Isabelle Godbout6 · Annie Poirier7 · Karina Prévost2 · Claude Spence1 · Maud‑Christine Chouinard8 · Hervé Tchala Vignon Zomahoun9,10 · Lobna Khadhraoui11 · José Massougbodji11 · Mathieu Bujold12 · Pierre Pluye12 · Catherine Hudon1,13 Accepted: 28 September 2020 © Springer Nature Switzerland AG 2020
Abstract Background Some patients with complex healthcare needs become high users of healthcare services. Case management allows these patients and their interprofessional team to work together to evaluate their needs, priorities and available resources. High-user patients must make an informed decision when choosing whether to engage in case management and currently there is no tool to support them. Objective The objective of this study was to develop and conduct a pilot alpha testing of a patient decision aid that supports high-user patients with complex needs and the teams who guide those patients in shared decision making when engaging in case management. Methods We chose a user-centered design to co-develop a patient decision aid with stakeholders informed by the Ottawa Research Institute and International Patient Decision Aid Standards frameworks. Perceptions and preferences for the patient decision aid’s content and format were assessed with patients and clinicians and were iteratively collected through interviews and focus groups. We developed a prototype and assessed its acceptability by using a think-aloud method and a questionnaire with three patient-partners, six clinicians and seven high-user patients with complex needs. Results The three rounds of evaluation to assess the decision aid’s acceptability highlighted comments related to simplicity, readability and visual aspect. A section presenting clinical vignettes including story telling was identified as the most helpful. Conclusions We created and evaluated a patient decision aid. Considering the positive comments, we believe that this aid has the potential to help high-user patients with complex care needs make better choices concerning case management. Plain Language Summary Some patients are living with physical and mental health problems. They also may have handicaps and unsuitable backgrounds. This may lead them to use health services more often. Case management is a service offered by a team of health professionals. They help patients to decide what is important to them based on their values and preferences. Currently, no tools exist for that service. We built and assessed a tool to support patients in their decisions. With this tool, they think about engaging in case management or continuing with usual care. They can also postpone their decision to a later time. This tool will present data based on scientific studies about case management. It will help patients to clarify their values and preferences to make the best decisi
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