Development and initial evaluation of a patient decision aid to support decision-making in care-seeking patients with subacromial pain syndrome in primary care.

OBJECTIVES

To describe the development and initial evaluation of a patient decision aid tailored for care-seeking patients with subacromial pain syndrome (SAPS) in primary care.

METHODS

A previously tested decision aid was adapted using the ADAPT guidance, with additional items developed based on the International Patient Decision Aid Standards and the Ottawa Decision Support Framework. A prototype was alpha-tested through think-aloud interviews with 10 patients and 10 healthcare professionals from various disciplines. Participants rated their readiness using the Preparation for Decision-Making (PrepDM) questionnaire and assessed face validity via the QQ-10 questionnaire. Feedback from participants, a project group, and a reference group (n = 26) informed revisions. The updated prototype was beta-tested with 23 primary care patients. Patients completed the Shoulder Pain and Disability Index (SPADI), EQ-5D-3L, and Decisional Conflict Scale (DCS) before, after, and two weeks following exposure to the decision aid. The Decision Regret Scale (DRS) was completed after two weeks. Thirteen follow-up interviews were conducted, guided by the SUNDAE reporting framework.

RESULTS

The final prototype included 10 treatment options and was considered acceptable and helpful during alpha-testing. Beta-testing showed a reduction in DCS from 40 ± 18 at baseline to 25 ± 18 after two weeks, indicating reduced decisional conflict. The DRS score (25 ± 9) reflected low regret. SPADI and EQ-5D-3L scores remained stable. Interviews confirmed high acceptability and practical value in clinical settings.

CONCLUSIONS

The decision aid shows promise in supporting shared decision-making for SAPS in primary care.

PRACTICE IMPLICATIONS: Further evaluation is needed to assess long-term impact and implementation.