Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA.
Patient Educ Couns. 2010 Feb;78(2):166-8. doi: 10.1016/j.pec.2009.06.013. Epub 2009 Aug 7.
Decision aids (DAs) have been shown to facilitate shared decision making about cancer screening. However, little data exist on optimal strategies for dissemination. Our objective was to compare different decision aid distribution models.
Eligible patients received video decision aids for prostate cancer (PSA) or colon cancer screening (CRC) through 4 distribution methods. Outcome measures included DA loans (N), % of eligible patients receiving DA, and patient and provider satisfaction.
Automatically mailing DAs to all age/gender appropriate patients led to near universal receipt by screening-eligible patients, but also led to ineligible patients receiving DAs. Three different elective (non-automatic) strategies led to low rates of receipt. Clinician satisfaction was higher when patients viewed the DA before the visit, and this model facilitated implementation of the screening choice. Regardless of timing or distribution method, patient satisfaction was high.
An automatic DA distribution method is more effective than relying on individual initiative. Enabling patients to view the DA before the visit is preferred.
Systematically offering DAs to all eligible patients before their appointments is the ideal strategy, but may be challenging to implement.
决策辅助工具（DAs）已被证明可以促进有关癌症筛查的共同决策。然而，关于传播的最佳策略的数据很少。我们的目的是比较不同的决策辅助工具分发模型。
符合条件的患者通过 4 种分发方法接受前列腺癌（PSA）或结肠癌筛查（CRC）的视频决策辅助工具。结果衡量标准包括 DA 贷款（N）、接受 DA 的符合条件的患者比例以及患者和提供者的满意度。
自动向所有年龄/性别合适的患者邮寄 DA，导致几乎所有符合筛查条件的患者都收到了 DA，但也导致不符合条件的患者收到了 DA。三种不同的选择性（非自动）策略导致接收率较低。当患者在就诊前观看 DA 时，临床医生的满意度更高，这种模式促进了筛查选择的实施。无论时间或分发方法如何，患者满意度都很高。
自动 DA 分发方法比依赖个人主动性更有效。使患者能够在就诊前观看 DA 是首选。
在预约前向所有符合条件的患者系统地提供 DA 是理想的策略，但实施可能具有挑战性。
