Creating open-access, evidence-based decision aids for patients with skin disease

Article type
Authors
Dellavalle RP1, Cameron M2, Henderin C2, Reed A2, McLellan C3, O'Neil AI3, Boyal S2, Tan J4
1University of Colorado
2Windsor Clinical Research Inc.
3University of Windsor
4University of Western Ontario
Abstract
Background:
Millions of people globally suffer from common dermatology ailments such as acne and psoriasis and may benefit from shared decision-making tools to improve their health care.

Objectives:
To introduce online patient decision aids (PDAs) for skin disease, describe PDA content development from dermatology evidence-based guidelines and systematic reviews, and share lessons learned from iterative patient and physician review of these decision aids.

Methods:
PDAs were developed in accordance with International Patient Decision Aid Standards. Content was extracted from current practice guidelines and primary research. English comprehension was set to an 8th grade reading level in an interactive online platform. Development involved iterative stakeholder feedback through focus groups and surveys of Canadian patients, and surveys of international healthcare professionals. Each of these stages informed changes to the decision aid content and format.

Results:
We created two online patient decision aids for common dermatological diseases with multiple therapies: acne and psoriasis (available at https://www.informed-decisions.org), and have two more PDAs in development for hidradenitis suppurativa and rosacea. Among patients, demand for decision support tools and satisfaction with the content and format of both PDAs was high. Physicians indicated high approval of the PDA content and function, and strong interest in PDA use with patients. A lack of consistent measures of acne treatment efficacy and safety limited the available data for presentation in the low-numeracy format required for the acne PDA.

Conclusions:
There is unmet demand for decision support tools for dermatology. Our PDAs for acne and psoriasis facilitate the provision of informed shared decision-making in dermatology.

Patient or healthcare consumer involvement:
These patient decision aids for skin diseases have been developed through an iterative process involving both patient and physician feedback.