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Wieringa TH, Kunneman M, Rodriguez-Gutierrez R, Montori VM, de Wit M, Smets EMA, Schoonmade LJ, Spencer-Bonilla G, Snoek FJ. A systematic review of decision aids that facilitate elements of shared decision-making in chronic illnesses: a review protocol. Syst Rev 2017; 6:155. [PMID: 28784186 PMCID: PMC5545866 DOI: 10.1186/s13643-017-0557-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 08/01/2017] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Shared decision-making (SDM) is a patient-centred approach in which clinicians and patients work side-by-side to decide together on the best course of action for each patient's particular situation. Six key elements of SDM can be distinguished: situation diagnosis, choice awareness, option clarification, discussion of harms and benefits, deliberation of patient preferences and making the decision. Decision aids (DAs) are tools that facilitate SDM. The impact of DAs for chronic illnesses on SDM, clinical and patient reported outcomes remains uncertain. METHODS We will perform a systematic review aiming to describe (a) which SDM elements are incorporated in DAs for adult patients with chronic conditions and (b) the effects of DA use on SDM, clinical and patient reported outcomes. This manuscript reports on the protocol for this systematic review. The following databases will be searched for relevant articles: PubMed, Embase, Web of Science, CINAHL and PsycINFO, from their inception to October 2016. We will ascertain ongoing research by querying experts and searching trial registries. To enhance feasibility, we will limit the review to randomized controlled trials (RCTs) including patients with chronic cardiovascular and/or respiratory diseases and/or diabetes. SDM elements incorporated in DAs, DA effects and DA itself will be described. DISCUSSION This study will characterize DAs for chronic illness and will provide an overview of their effects on SDM, clinical and patient reported outcomes. We anticipate this review will bring to light knowledge gaps and inform further research into the design and use of DAs for patients with chronic conditions. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number: CRD42016050320 .
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Affiliation(s)
- Thomas H Wieringa
- Department of Medical Psychology, VU University Medical Center (VUMC), De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands. .,Amsterdam Public Health research institute, VU University Medical Center and Academic Medical Center, Amsterdam, the Netherlands.
| | - Marleen Kunneman
- Knowledge and Evaluation Research Unit, Mayo Clinic, 200 First street SW, Rochester, MN, 55905, USA
| | - Rene Rodriguez-Gutierrez
- Knowledge and Evaluation Research Unit, Mayo Clinic, 200 First street SW, Rochester, MN, 55905, USA.,Division of Endocrinology, Department of Internal Medicine, "Dr. Jose E. González" University Hospital, Autonomous University of Nuevo Leon, Avenue Gonzalitos s/n, Mitras Centro and Avenue Francisco I. Madero, 66460, Monterrey, Nuevo Leon, Mexico
| | - Victor M Montori
- Knowledge and Evaluation Research Unit, Mayo Clinic, 200 First street SW, Rochester, MN, 55905, USA
| | - Maartje de Wit
- Department of Medical Psychology, VU University Medical Center (VUMC), De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands.,Amsterdam Public Health research institute, VU University Medical Center and Academic Medical Center, Amsterdam, the Netherlands
| | - Ellen M A Smets
- Department of Medical Psychology, Academic Medical Center (AMC), Meibergdreef 9, 1100 DD, Amsterdam, the Netherlands
| | - Linda J Schoonmade
- Medical Library, VU University, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands
| | - Gabriela Spencer-Bonilla
- Knowledge and Evaluation Research Unit, Mayo Clinic, 200 First street SW, Rochester, MN, 55905, USA
| | - Frank J Snoek
- Department of Medical Psychology, VU University Medical Center (VUMC), De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands.,Amsterdam Public Health research institute, VU University Medical Center and Academic Medical Center, Amsterdam, the Netherlands.,Department of Medical Psychology, Academic Medical Center (AMC), Meibergdreef 9, 1100 DD, Amsterdam, the Netherlands
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Jongstra S, Beishuizen C, Andrieu S, Barbera M, van Dorp M, van de Groep B, Guillemont J, Mangialasche F, van Middelaar T, Moll van Charante E, Soininen H, Kivipelto M, Richard E. Development and Validation of an Interactive Internet Platform for Older People: The Healthy Ageing Through Internet Counselling in the Elderly Study. Telemed J E Health 2016; 23:96-104. [PMID: 27463120 DOI: 10.1089/tmj.2016.0066] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND A myriad of Web-based applications on self-management have been developed, but few focus on older people. In the face of global aging, older people form an important target population for cardiovascular prevention. This article describes the full development of an interactive Internet platform for older people, which was designed for the Healthy Ageing Through Internet Counselling in the Elderly (HATICE) study. We provide recommendations to design senior-friendly Web-based applications for a new approach to multicomponent cardiovascular prevention. METHODS The development of the platform followed five phases: (1) conceptual framework; (2) platform concept and functional design; (3) platform building (software and content); (4) testing and pilot study; and (5) final product. RESULTS We performed a meta-analysis, reviewed guidelines for cardiovascular diseases, and consulted end users, experts, and software developers to create the platform concept and content. The software was built in iterative cycles. In the pilot study, 41 people aged ≥65 years used the platform for 8 weeks. Participants used the interactive features of the platform and appreciated the coach support. During all phases adjustments were made to incorporate all improvements from the previous phases. The final platform is a personal, secured, and interactive platform supported by a coach. DISCUSSION When carefully designed, an interactive Internet platform is acceptable and feasible for use by older people with basic computer skills. To improve acceptability by older people, we recommend involving the end users in the process of development, to personalize the platform and to combine the application with human support. The interactive HATICE platform will be tested for efficacy in a multinational randomized controlled trial (ISRCTN48151589).
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Affiliation(s)
- Susan Jongstra
- 1 Department of Neurology, Academic Medical Center, University of Amsterdam , Amsterdam, The Netherlands
| | - Cathrien Beishuizen
- 1 Department of Neurology, Academic Medical Center, University of Amsterdam , Amsterdam, The Netherlands
| | - Sandrine Andrieu
- 2 INSERM, University of Toulouse , Toulouse, France .,3 Department of Epidemiology and Public Health, Toulouse University Hospital , Toulouse, France
| | - Mariagnese Barbera
- 4 Institute of Clinical Medicine/Neurology, University of Eastern Finland , Kuopio, Finland
| | | | | | | | - Francesca Mangialasche
- 6 Ageing Research Center, Karolinska Institutet/Stockholm University , Stockholm, Sweden
| | - Tessa van Middelaar
- 1 Department of Neurology, Academic Medical Center, University of Amsterdam , Amsterdam, The Netherlands .,7 Department of Neurology, Radboud University Medical Center , Nijmegen, The Netherlands
| | - Eric Moll van Charante
- 8 Department of General Practice, Academic Medical Centre, University of Amsterdam , Amsterdam, The Netherlands
| | - Hilkka Soininen
- 4 Institute of Clinical Medicine/Neurology, University of Eastern Finland , Kuopio, Finland
| | - Miia Kivipelto
- 4 Institute of Clinical Medicine/Neurology, University of Eastern Finland , Kuopio, Finland .,6 Ageing Research Center, Karolinska Institutet/Stockholm University , Stockholm, Sweden .,9 Chronic Disease Prevention Unit, National Institute for Health and Welfare , Helsinki, Finland
| | - Edo Richard
- 1 Department of Neurology, Academic Medical Center, University of Amsterdam , Amsterdam, The Netherlands .,7 Department of Neurology, Radboud University Medical Center , Nijmegen, The Netherlands
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Bolle S, Romijn G, Smets EMA, Loos EF, Kunneman M, van Weert JCM. Older Cancer Patients' User Experiences With Web-Based Health Information Tools: A Think-Aloud Study. J Med Internet Res 2016; 18:e208. [PMID: 27457709 PMCID: PMC4977420 DOI: 10.2196/jmir.5618] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 06/13/2016] [Accepted: 06/28/2016] [Indexed: 12/03/2022] Open
Abstract
Background Health information is increasingly presented on the Internet. Several Web design guidelines for older Web users have been proposed; however, these guidelines are often not applied in website development. Furthermore, although we know that older individuals use the Internet to search for health information, we lack knowledge on how they use and evaluate Web-based health information. Objective This study evaluates user experiences with existing Web-based health information tools among older (≥ 65 years) cancer patients and survivors and their partners. The aim was to gain insight into usability issues and the perceived usefulness of cancer-related Web-based health information tools. Methods We conducted video-recorded think-aloud observations for 7 Web-based health information tools, specifically 3 websites providing cancer-related information, 3 Web-based question prompt lists (QPLs), and 1 values clarification tool, with colorectal cancer patients or survivors (n=15) and their partners (n=8) (median age: 73; interquartile range 70-79). Participants were asked to think aloud while performing search, evaluation, and application tasks using the Web-based health information tools. Results Overall, participants perceived Web-based health information tools as highly useful and indicated a willingness to use such tools. However, they experienced problems in terms of usability and perceived usefulness due to difficulties in using navigational elements, shortcomings in the layout, a lack of instructions on how to use the tools, difficulties with comprehensibility, and a large amount of variety in terms of the preferred amount of information. Although participants frequently commented that it was easy for them to find requested information, we observed that the large majority of the participants were not able to find it. Conclusions Overall, older cancer patients appreciate and are able to use cancer information websites. However, this study shows the importance of maintaining awareness of age-related problems such as cognitive and functional decline and navigation difficulties with this target group in mind. The results of this study can be used to design usable and useful Web-based health information tools for older (cancer) patients.
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Affiliation(s)
- Sifra Bolle
- Amsterdam School of Communication Research/ ASCoR, Department of Communication Science, University of Amsterdam, Amsterdam, Netherlands.
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