35th AM (2024) - Poster Session-Development of a Point-of-Care Patient Decision

Development of a Point-of-Care Patient Decision

Pdf Summary

The document describes the development of a Point-of-Care Shared Decision-Making Tool aimed at facilitating the choice of Medication for Opioid Use Disorder (MOUD). It highlights the challenges patients face due to limited and inaccurate information, often exacerbated by stigma, when making treatment decisions. The efficacy of MOUD interventions, such as methadone, buprenorphine, and injectable naltrexone, is well-documented in reducing mortality and risky behavior, increasing treatment adherence, and improving cost-effectiveness.<br /><br />The shared decision-making model, emphasized in this project, promotes collaboration between patients and clinicians, as opposed to paternalistic approaches. It improves patient knowledge, aligns decisions with patient values, enhances communication, quality of life, and reduces indecision and addiction severity.<br /><br />Despite existing evidence, no evidence-based Patient Decision Aid (PtDA) exists in a user-friendly format for MOUD decision-making at the point-of-care. The project objectives included a literature review on shared decision-making, identifying factors influencing MOUD choices, developing a single-page PtDA, and refining this tool based on stakeholder feedback.<br /><br />The PtDA was drafted, taking into account feedback to simplify the wording, incorporate graphics, and streamline organization to improve usability. A critical aim was to present a menu of treatment options rather than a forced choice, transitioning from a scarcity-based system to one allowing shared agency in treatment selection.<br /><br />Significant factors affecting patient choice were also identified, including awareness of options, side effects, medication delivery convenience, treatment goals, stigma concerns, and pain management. The document concludes that while essential, creating a comprehensive PtDA according to international standards may require adaptations beyond a single-page format, suggesting a need for further research to tailor decision aids effectively for diverse populations.

Keywords

Point-of-Care

Shared Decision-Making

Opioid Use Disorder

Medication Choice

Patient Decision Aid

Methadone

Buprenorphine

Naltrexone

Treatment Adherence

Stigma

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