Involving consumers in healthcare decisions is important for high quality care. We previously tested a brief, consumer-led intervention consisting of three questions in a trial employing trained, standardized patients. The intervention enhanced discussion of evidence and increased patient involvement. We now report a research translation study which tested implementation with real patients at a reproductive and sexual health clinic.
We worked with clinic staff to build a website with video clips demonstrating the questions in action, and produced supporting materials (pamphlet, consultation summary sheet, fridge magnet). Before their consultation, patients were invited to view a 4-minute video-clip on a supplied tablet and given the other materials and access to the website (www.askshareknow.com.au). They completed questionnaires at baseline (T1), immediately post-consultation (T2) and two weeks later (T3). 195 patients agreed to participate and provided baseline data. 155 watched the video clip; 121 and 95 completed post-consultation questions at T2 and T3 respectively. 84/121 (69%) asked at least one of the questions in their consultation, and 29% asked all three questions.
Question asking was strongly associated with decision making. Among those who made a treatment decision, 87% asked at least one question and 43% asked all three questions, compared with 50% and 14% respectively of those who did not make a decision (P<0.0001). 84% of those who made a decision rated the questions as very (53%) or somewhat helpful (31%) for decision making. 95% of all patients reported they would definitely (72%) or probably (22%) recommend the questions to others. Two weeks later 82% could recall Question 1, 47% could recall all three questions, and 83% reported they would ask the questions again. Implementation of this brief, effective and cheap intervention was feasible within routine clinical practice, and supports evidence-based, patient-centred care.
