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What Are Decision Aids?

Decision aids are tools — they can take the form of brochures, videos, or online worksheets and materials — designed to help you better understand your options and clarify what matters to you.

You can use a decision aid while working together with your health care team to decide what is most important to you in regard to your health and treatment options.

For example: Do you want to be able to maintain your current activities? Is living longer your top concern? Would you prefer to avoid surgery? Decision aids can help you answer these questions, especially if you are choosing among several options.

Decision aids can help people make informed choices about:

  • Procedures
  • Surgery
  • Medications
  • Genetic testing
  • Screening tests

Decision aids don't take the place of a thoughtful discussion with your health care team. The best aids support shared decision-making, which is when patients and clinicians work as a team to make care decisions.

These tools should also reflect the best-known evidence — that is what the science tells us about how each treatment works.

Decision aids are most helpful when:

  1. There is more than one reasonable choice for treatment, and either the options have similar results or important trade-offs.

    For instance, when a stent is placed in a coronary artery, there are two types: a bare metal stent or a stent that is coated in a material to prevent the artery from blocking again. The bare metal stent requires a shorter treatment with a blood thinner. Some patients would choose a shorter treatment with blood thinners instead of aggressive blood thinners to reduce the risk of another blockage. That is an individual decision, and a decision aid can help patients make a better choice for them.

  2. The benefits and drawbacks of a given treatment would have different value to different people.

    For example, medications for depression may vary when it comes to weight gain, sex drive, sleep quality, and how and when to stop taking them. For high blood pressure, diuretics may be great, but they can also make problems like incontinence or prostate enlargement worse.

  3. There is no clear option. Good decision aids can highlight the lack of data and still support a conversation.

A Decision Aid Helps a Patient Prepare for a Health Decision by:

  1. Providing facts about a person’s condition and the options for treatment.
  2. Helping patients clearly define their values, and thoughts about what is most important for them during treatment and their top health goal.
  3. Helping patients share their values with their doctors to come up with the best treatment plan.
Source: IPDAS Collaboration checklist

After being diagnosed with a condition, decision aids can help you:

  • Gather information about your condition.
  • Learn about each option for treatment and related risks.
  • Think about and factor in what matters to you.
  • Better define your short- and long-term treatment goals.
  • Choose among different types of care.
  • Make an informed decision together with your care team.

These tools, along with conversations with your health care team and perhaps connecting with other people through support groups, can guide you as you navigate the different treatment paths you could take.

Typically, decision aids will outline things we know to be true (called objective considerations) and personal opinion or feelings (called subjective considerations) to help determine how they fit with your goals.


 Examples

 

 Objective
  • What clinical use tells us
  • What evidence tells us
  • Pros and cons of each treatment option


 Subjective
  • Your health goals
  • Your values, needs and preferences
  • Your acceptance and feelings about each treatment

Decision aids can take many forms. For the most part, these tools are designed to provide clear, consistent information about or explanation of the following:

  • Your health condition in plain language. The tools may include pictures, charts or graphs to help you understand how your condition affects your body.
  • Choices for screenings, medications or procedures. In some cases, one option might be to closely watch your condition for changes.
  • The pros and cons of each treatment, procedure or test, as well as any uncertainties.
  • Questions about your health goals and any special considerations, including what you prefer and need (for example, when deciding whether to use or keep using an implantable cardioverter defibrillator (ICD), a small device  placed in the chest or abdomen to help control dangerous heart rhythm problems).

Decision aids can help you make more informed choices about your care that you can feel good about.

There are many different types of decision aids. Some are online. Others are designed to be used during your doctor visit. Because people learn in different ways, the information may be presented in many formats:

  • Printed materials
  • Videos
  • Web-based tools

For example, a decision aid about taking heart failure medication might be available in any or all of the following: as an online video, a brochure in a doctor’s office or an interactive website that includes a worksheet with scenarios based on your answers to a set of questions.

Many decision aids are being added into electronic medical records. That makes it easier for the tools to be used as a routine part of a health visit when someone is diagnosed with a condition.

Patients who use decision aids tend to have:

  • Better knowledge about their condition and treatment options
  • More accurate expectations of the benefits and risks of each option and how those options work
  • Made decisions that are more in line with their personal preferences and goals
  • Played a more active role in their care
  • Greater confidence/feeling more sure of care plans
  • Clearly talked with their health care team and in general feel more satisfied with care

Studies also show that patients who used a decision aid were less likely to choose an invasive elective surgery than those who did not consult a decision aid.

More Benefits

In addition, decision aids allow you to partner more closely with your doctor in making decisions.

Doctor’s offices are busy. Sometimes, there isn’t enough time to go over everything, and patients may not know the right questions to ask.

Even when health care professionals fully discuss the risks and benefits of one treatment over another, patients may not understand the information. Decision aids can help bridge this gap.

In addition to the resources on CardioSmart.org, you can find out more about decision aids and shared decision-making through:

The Commonwealth Fund: “Helping Patients Make Better Treatment Choices with Decision Aids”

Mayo Clinic: Center for Innovation

Mayo Clinic Shared Decision Making National Resource Center
 
International Patient Decision Aid Standards Collaboration

SharedDecisionMaking.org

  • Last Edited 08/31/2017