Background
Methods
Study design
The statin choice decision aid and the diabetes medication choice decision aid
The statin choice decision aid
The diabetes medication choice decision aid
Study participants
Survey data
Log file data
Demographic data
Statistical analysis
Results
Variable | Description | Survey Respondents
n = 105% or m(SD) | All Clinicians
n = 262% or m(SD) |
---|---|---|---|
Type of clinician | Nurse Practitioner | 14.4% | 16.0% |
Physician Assistant | 3.8% | 3.1% | |
Physician | 37.5% | 35.1% | |
Physician in Training | 44.2% | 45.8% | |
Sex | Male | 49.5% | 45.2% |
Age | – | 40.7 (12.2) | 40.6 (12.0) |
Years in Practice | – | 13.6 (12.3) | 13.5 (12.0) |
Time period | Survey Respondents (n = 105) | All Clinicians (n = 262) | ||||||
---|---|---|---|---|---|---|---|---|
DMCDA access | SCDA access | DMCDA access | SCDA access | |||||
# of times | % of clinicians | # of times | % of clinicians | # of times | % of clinicians | # of times | % of clinicians | |
Six months pre- survey | 14 | 10.5% | 552 | 55.2% | 21 | 6.9% | 1151 | 45.4% |
Six months post-survey | 11 | 7.6% | 363 | 46.7% | 12 | 3.4% | 819 | 34.0% |
Entire 12 months period | 25 | 15.2% | 915 | 62.3% | 33 | 9.1% | 1970 | 51.1% |
Domain | Category | DMCDA% | SCDA % |
---|---|---|---|
Use | Routinely used | 28.4% | 80.6% |
Knowledge Barriers | Unfamiliar with decision aid | 42.3% | 6.9% |
Unaware of EMR link | 43.1% | 47.4% | |
Attitude Barriers | Not helpful | 19.6% | 15.8% |
Not accurate | 1.0% | 5.3% | |
Attitude Facilitators | Very useful | 29.6% | 56.4% |
External Barrier | Time constraints | 10.7% | 21.1% |
External Facilitator | Appropriate amount of information | 85.2% | 94.8% |
Often impacts treatment decision | 22.2% | 42.3% | |
Type of use | Only discuss topics patient is interested in | 42.3% | 17.9% |
Only discuss topics I find relevant | 46.2% | 60.3% | |
Discuss all topics (use as intended) | 11.5% | 21.8% |
Domain | DMCDA | SCDA |
---|---|---|
Knowledge Barriers | -“I don’t have experience using all the meds listed on the decision aid” | -“Don’t know enough about it” |
-“I prefer to send my patients to Endocrinology to discuss treatment options” | -“Often forget it exists” | |
Attitude Barriers | -“For most of my patients there is an appropriate next step and giving them choices for medications that I would not prescribe doesn’t make sense” | -“Decision aid seems to underestimate benefit” |
-“First choice should be metformin” | -“Patients never choose to use a statin with this decision aid” | |
-“A patient may choose a newer pricey medication with the attractive profile with the attitude of ‘Well, I’m not paying for it’” | ||
External Barrier | -“Computer in rooms often do not pull up the decision aid fast enough” | -“Most patients are already on statins” |
-“Decision aid is slow to load. Laminated cards would be helpful” | ||
-“Sometimes discussing options over the phone after test results and hard to use the decision aid remotely” | ||
-“I have a very small number of patients on medications for diabetes” | ||
-“Most of my patients are already on insulin and/or oral agents” | ||
-“Navigating the tool seems a bit clunky” |