Electronic supplementary material
The online version of this article (doi:10.1186/1472-6947-12-48) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
OH participated in the study design and coordination, developed the concept for data analysis, carried out the study, performed the statistical analyses, and drafted the manuscript. HK participated in the study design and coordination, the rationale for the data analyses, carried out the study, and helped to draft the manuscript. TK participated in the study design and coordination, the rationale for the data analyses, and helped to draft the manuscript. NDB participated in the study design and coordination, the rationale for the data analyses, and helped to draft the manuscript. All authors read and approved the final manuscript.
The successful implementation of decision aids in clinical practice initially depends on how clinicians perceive them. Relatively little is known about the acceptance of decision aids by physicians and factors influencing the implementation of decision aids from their point of view. Our electronic library of decision aids (arriba-lib) is to be used within the encounter and has a modular structure containing evidence-based decision aids for the following topics: cardiovascular prevention, atrial fibrillation, coronary heart disease, oral antidiabetics, conventional and intensified insulin therapy, and unipolar depression. The aim of our study was to evaluate the acceptance of arriba-lib in primary care physicians.
We conducted an evaluation study in which 29 primary care physicians included 192 patients. The physician questionnaire contained information on which module was used, how extensive steps of the shared decision making process were discussed, who made the decision, and a subjective appraisal of consultation length. We used generalised estimation equations to measure associations within patient variables and traditional crosstab analyses.
Only a minority of consultations (8.9%) was considered to be unacceptably extended. In 90.6% of consultations, physicians said that a decision could be made. A shared decision was perceived by physicians in 57.1% of consultations. Physicians said that a decision was more likely to be made when therapeutic options were discussed “detailed”. Prior experience with decision aids was not a critical variable for implementation within our sample of primary care physicians.
Our study showed that it might be feasible to apply our electronic library of decision aids (arriba-lib) in the primary care context. Evidence-based decision aids offer support for physicians in the management of medical information. Future studies should monitor the long-term adoption of arriba-lib in primary care physicians.