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Treatment of almost all medical conditions has been affected by the COVID-19 pandemic. NICE has issued rapid update guidelines in relation to many of these. This guidance is changing frequently. Please visit https://www.nice.org.uk/covid-19 to see if there is temporary guidance issued by NICE in relation to the management of this condition, which may vary from the information given below.
When helping patients make decisions about their health, there may be many different treatment options, each with different outcomes. Decision aids are designed to provide concise and evidenced-based information to help decide between different options.
Many of these decision aids were initially developed by the MAGIC ('making good decisions in collaboration) project. It looked at how to embed best practice in shared decision making.
Decision aids have great potential for improving individuals' healthcare experiences, such as helping patients feel involved and listened to, and giving them a say in what happens to them. Getting patients engaged can bring added benefits. It is claimed that, when patients are engaged and follow their treatment plans, their health outcomes improve and resources tend to be used more effectively. NHS England now provides a number of decision support tools (see reference link for those currently available).
Decision aids can be a valuable tool for shared medical decision making. Their quality and usefulness can be maximised by involving users in their creation and by attending to key considerations in their design (particularly avoiding format bias), implementation, and appraisal.
A Cochrane review concluded that:
- People exposed to decision aids feel more knowledgeable, better informed, and clearer about their values, and they probably have a more active role in decision making and more accurate risk perceptions.
- Further research is needed on the effects on adherence with the chosen option, cost-effectiveness, and use with lower literacy populations.
A further review found that decision aids improve older adults' knowledge, increase their risk perception, decrease decisional conflict and seem to enhance participation in shared decision making.
However other research has shown only some positive behavioural effects of decision aids with variable results and outcomes.
Further reading and references
Making decisions about your care; National Institute of Health and Care Excellence (NICE).
Shared Decision Making, Summary guide; NHS England and NHS Improvement. 2019.
An introduction to patient decision aids; BMJ. 2013 Jul 23347:f4147.
Decision support tools; NHS England.
Koon S; Important Considerations for Design and Implementation of Decision Aids for Shared Medical Decision Making. Perm J. 202024:19.064. doi: 10.7812/TPP/19.064. Epub 2019 Dec 30.
Stacey D, Legare F, Lewis K, et al; Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev. 2017 Apr 124(4):CD001431. doi: 10.1002/14651858.CD001431.pub5.
van Weert JC, van Munster BC, Sanders R, et al; Decision aids to help older people make health decisions: a systematic review and meta-analysis. BMC Med Inform Decis Mak. 2016 Apr 2116:45. doi: 10.1186/s12911-016-0281-8.
Gultzow T, Zijlstra DN, Bolman C, et al; Decision aids to facilitate decision making around behavior change in the field of health promotion: A scoping review. Patient Educ Couns. 2021 Jun104(6):1266-1285. doi: 10.1016/j.pec.2021.01.015. Epub 2021 Jan 18.