arriba-lib: evaluation of an electronic library of decision aids in primary care physicians

doi:10.1186/1472-6947-12-48

BMC Med Inform Decis Mak. 2012; 12: 48.

Published online 2012 June 6. doi: 10.1186/1472-6947-12-48

PMCID: PMC3461416

arriba-lib: evaluation of an electronic library of decision aids in primary care physicians

Oliver Hirsch,¹ Heidemarie Keller,¹ Tanja Krones,¹ and Norbert Donner-Banzhoff¹

¹Department of General Practice/Family Medicine, University of Marburg, Marburg, Germany

Corresponding author.

Oliver Hirsch: oliver.hirsch/at/staff.uni-marburg.de; Heidemarie Keller: kellerhe/at/staff.uni-marburg.de; Tanja Krones: tanja.krones/at/usz.ch; Norbert Donner-Banzhoff: norbert/at/staff.uni-marburg.de

Received August 30, 2011; Accepted May 21, 2012.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

The successful implementation of decision aids in clinical practice initially depends on how clinicians perceive them. Relatively little is known about the acceptance of decision aids by physicians and factors influencing the implementation of decision aids from their point of view. Our electronic library of decision aids (arriba-lib) is to be used within the encounter and has a modular structure containing evidence-based decision aids for the following topics: cardiovascular prevention, atrial fibrillation, coronary heart disease, oral antidiabetics, conventional and intensified insulin therapy, and unipolar depression. The aim of our study was to evaluate the acceptance of arriba-lib in primary care physicians.

Methods

We conducted an evaluation study in which 29 primary care physicians included 192 patients. The physician questionnaire contained information on which module was used, how extensive steps of the shared decision making process were discussed, who made the decision, and a subjective appraisal of consultation length. We used generalised estimation equations to measure associations within patient variables and traditional crosstab analyses.

Results

Only a minority of consultations (8.9%) was considered to be unacceptably extended. In 90.6% of consultations, physicians said that a decision could be made. A shared decision was perceived by physicians in 57.1% of consultations. Physicians said that a decision was more likely to be made when therapeutic options were discussed “detailed”. Prior experience with decision aids was not a critical variable for implementation within our sample of primary care physicians.

Conclusions

Our study showed that it might be feasible to apply our electronic library of decision aids (arriba-lib) in the primary care context. Evidence-based decision aids offer support for physicians in the management of medical information. Future studies should monitor the long-term adoption of arriba-lib in primary care physicians.

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