BMC Med Inform Decis Mak - The design of a low literacy decision aid about rheumatoid arthritis medications developed in three languages for use during the clinical encounter.

Tópicos

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Resumo

CKGROUND: Shared decision-making in rheumatoid arthritis (RA) care is a priority among policy makers, clinicians and patients both nationally and internationally. Demands on patients to have basic knowledge of RA, treatment options, and details of risk and benefit when making medication decisions with clinicians can be overwhelming, especially for those with limited literacy or limited English language proficiency. The objective of this study is to describe the development of a medication choice decision aid for patients with rheumatoid arthritis (RA) in three languages using low literacy principles.METHODS: Based on the development of a diabetes decision aid, the RA decision aid (RA Choice) was developed through a collaborative process involving patients, clinicians, designers, decision-aid and health literacy experts. A combination of evidence synthesis and direct observation of clinician-patient interactions generated content and guided an iterative process of prototype development.RESULTS: Three iterations of RA Choice were developed and field-tested before completion. The final tool organized data using icons and plain language for 12 RA medications across 5 issues: frequency of administration, time to onset, cost, side effects, and special considerations. The tool successfully created a conversation between clinician and patient, and garnered high acceptability from clinicians.CONCLUSIONS: The process of collaboratively developing an RA decision aid designed to promote shared decision making resulted in a graphically-enhanced, low literacy tool. The use of RA Choice in the clinical encounter has the potential to enhance communication for RA patients, including those with limited health literacy and limited English language proficiency.

Resumo Limpo

ckground share decisionmak rheumatoid arthriti ra care prioriti among polici maker clinician patient nation intern demand patient basic knowledg ra treatment option detail risk benefit make medic decis clinician can overwhelm especi limit literaci limit english languag profici object studi describ develop medic choic decis aid patient rheumatoid arthriti ra three languag use low literaci principlesmethod base develop diabet decis aid ra decis aid ra choic develop collabor process involv patient clinician design decisionaid health literaci expert combin evid synthesi direct observ clinicianpati interact generat content guid iter process prototyp developmentresult three iter ra choic develop fieldtest complet final tool organ data use icon plain languag ra medic across issu frequenc administr time onset cost side effect special consider tool success creat convers clinician patient garner high accept cliniciansconclus process collabor develop ra decis aid design promot share decis make result graphicallyenhanc low literaci tool use ra choic clinic encount potenti enhanc communic ra patient includ limit health literaci limit english languag profici

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