Hollanda De Sa Neto Herul, Habfast-Robertson Ines, Hempel-Bruder Christina, Durand Marie-Anne, Jacot-Sadowski Isabelle, Khazaal Yasser, Berlin Ivan, Selby Kevin
Lausanne University Hospital, Lausanne, Switzerland.
Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland.
JMIR Form Res. 2022 Apr 20;6(4):e32960. doi: 10.2196/32960.
Smoking cessation is an essential part of preventing and reducing the risk of smoking-associated morbidity and mortality. However, there is often little time to discuss smoking cessation in primary care. Decision aids (DAs) designed for clinic visits (encounter DAs) need to be clear, short, and concise to optimize therapeutic education, increase interaction, and improve the therapeutic alliance. Such a DA for smoking cessation could potentially improve counseling and increase the use of pharmacological treatments.
We aimed to collect feedback on an electronic encounter DA that facilitates physician-patient interaction and shared decision-making for smoking cessation in primary care.
We developed an electronic, encounter DA (howtoquit.ch) from a paper version created by our team in 2017 following user-centered design principles. The DA is a 1-page interactive website presenting and comparing medications for tobacco cessation and electronic cigarettes. Each smoking cessation medication has a drop down menu that presents additional information, a video demonstration, and prescribing information for physicians. To test the DA, we submitted a questionnaire to approximately 20 general practitioner residents of an academic general medicine department, 5 general practitioners, and 6 experts in the field of smoking cessation. The questionnaire consisted of 4 multiple-choice and 2 free-text questions assessing the usability or acceptability of the DA, the acquisition of new knowledge for practitioners, the perceived utility in supporting shared decision-making, perceived strengths and weaknesses, and whether the participants would recommend the tool to other clinicians.
In all, 6 residents, 3 general practitioners in private practice, and 2 tobacco cessation experts completed the questionnaire (N=11), with 4 additional experts providing open-text feedback. On the 11 questionnaires, the DA was rated as practical and intuitive (mean 4.6/5), and providers felt it supported shared decision-making (mean 4.4/5), as comparisons were readily possible. Inclusion of explanatory videos was seen as a bonus. Several changes were suggested, like grouping together similar medications and adding a landing page to briefly explain the site. Changes were implemented according to end-user comments.
The overall assessment of the encounter DA by a group of physicians and experts was positive. The ultimate objective is to have the tool deployed and easily accessible for all to use.
戒烟是预防和降低吸烟相关发病率和死亡率风险的重要组成部分。然而，在初级保健中，往往没有多少时间讨论戒烟问题。为门诊就诊设计的决策辅助工具（DAs）（即门诊决策辅助工具）需要清晰、简短且简洁，以优化治疗教育、增加互动并改善治疗联盟。这样一种戒烟决策辅助工具可能会改善咨询服务并增加药物治疗的使用。
我们旨在收集关于一种电子门诊决策辅助工具的反馈，该工具有助于初级保健中戒烟的医患互动和共同决策。
我们根据以用户为中心的设计原则，从我们团队在2017年创建的纸质版本开发了一种电子门诊决策辅助工具（howtoquit.ch）。该决策辅助工具是一个1页的交互式网站，展示并比较戒烟药物和电子烟。每种戒烟药物都有一个下拉菜单，提供更多信息、视频演示以及给医生的处方信息。为了测试该决策辅助工具，我们向一个学术普通内科部门的约20名全科医生住院医师、5名全科医生以及6名戒烟领域专家发放了问卷。问卷包括4个多项选择题和2个自由文本问题，评估决策辅助工具的可用性或可接受性、从业者获得的新知识、在支持共同决策方面的感知效用、感知的优势和劣势，以及参与者是否会向其他临床医生推荐该工具。
共有6名住院医师、3名私人执业全科医生和2名戒烟专家完成了问卷（N = 11），另有4名专家提供了开放式文本反馈。在11份问卷中，该决策辅助工具被评为实用且直观（平均4.6/5），提供者认为它支持共同决策（平均4.4/5），因为很容易进行比较。包含解释性视频被视为一项优点。有人提出了一些改进建议，比如将相似药物归为一组，并添加一个着陆页以简要解释该网站。根据最终用户的意见进行了改进。
一组医生和专家对门诊决策辅助工具的总体评价是积极的。最终目标是将该工具部署并让所有人都能轻松使用。
