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Developing a person-centred discrete choice experiment to promote shared decision making in the patient-pharmacist interaction

Developing a computer based decision aid tool (DAT) to help pharmacists manage chronic pain in primary care

Professor Mandy Ryan, University of Aberdeen

Chronic pain is a common problem among people in the UK. Pharmacists in the UK are increasingly being involved in the management of chronic pain within the primary care setting. Pain is a highly subjective experience and also preference-sensitive. It is a personal choice for a person experiencing pain whether or not an analgesic is necessary. Therefore, it is important that patients with chronic pain have a say in their treatment and healthcare professionals (HCP) take into account patients’ opinions when deciding what to prescribe. However, such shared-decision making is difficult to implement in practice due to time constraint during consultation, challenges in conveying health-related information to patients in an accessible format, different communication skills amongst HCPs, as well as difficulty in understanding patients’ preferences.

Given these challenges, we proposed to develop a computer-based decision-aid tool (DAT) that could be used by pharmacists when managing chronic pain in primary care. We will first search within the literature to identify existing DATs and for previous studies looking at what features of a treatment and what types of outcomes matter to patients with chronic pain. We will then collect the views of patients with chronic pain, and pharmacists and doctors involved in chronic pain management, to better understand the experiences surrounding the issue.

Following that, we will use all the information gathered to develop the DAT. This DAT will present information on chronic pain, treatment options and outcomes to patients in a video format. It will also include an interactive component which asks respondents to think about their health situation, consider treatment options and choose their preferred choice from a series of hypothetical options. The interaction during this choice exercise directs patients to think about what matters to them, helps them understand their values and forms expectation of likely health outcomes. At the end of the interaction with the DAT, a report will be generated and shared by the patient and pharmacist during the consultation. This report will contain information on patients’ preferences captured during the interaction with the DAT and can be used to guide shared decision making. Once the DAT is developed, we will evaluate the usability of the DAT with a few patients and pharmacists.

Finally, we will conduct a small trial to test the feasibility of using the DAT in practice, to determine what patients and pharmacists think about the DAT and assess patient satisfaction with the pharmacist-patient interaction. The findings from this small trial will be used to guide the development of a larger trial to test the effectiveness of the DAT in facilitating shared-decision making and improving decision quality for patients with chronic pain.

This project was awarded funding in September 2017 and is due to run for 24 months.

For more information see the detailed project description for more information.