Value of patient decision aids for shared decision-making in kidney failure

BackgroundIt is unknown how often Dutch patient decision aids are used during kidney failure treatment modality education and what their impact is on shared decision-making. ObjectivesWe determined the use of Three Good Questions, 'Overviews of options', and Dutch Kidney Guide by kidney healthcare professionals. Also, we determined patient-experienced shared decision-making. Finally, we determined whether the experience of shared decision-making among patients changed after a training workshop for healthcare professionals. DesignQuality improvement study. ParticipantsHealthcare professionals answered questionnaires regarding education/patient decision aids. Patients with estimated glomerular filtration rate Of 117 healthcare professionals, 56% applied shared decision-making by discussing Three Good Questions (28%), 'Overviews of options' (31%-33%) and Kidney Guide (51%). Of 182 patients, 61%-85% was satisfied with their education. Of worst scoring hospitals regarding shared decision-making, only 50% used 'Overviews of options'/Kidney Guide. Of best scoring hospitals 100% used them, needed less conversations (p = 0.05), provided information about all treatment options and more often provided information at home. After the workshop, patients' shared decision-making scores remained unchanged. ConclusionsThe use of specifically developed patient decision aids during kidney failure treatment modality education is limited. Hospitals that did use them had higher shared decision-making scores. However, the degree of shared decision-making experienced by patients remained unchanged after healthcare professionals were trained on shared decision-making and the implementation of patient decision aids.

Automated summary

This study aimed to investigate the frequency of Dutch healthcare professionals using patient decision aids during kidney failure treatment modality education and their impact on shared decision-making. The study found that only a portion of hospitals used decision aids and those that did had higher scores in shared decision-making. However, patients' shared decision-making scores remained unchanged after healthcare professionals were trained and implemented the decision aids.