The patient decision aid ‘Diagnostic testing for dementia or not’: Early uptake and first impressions

Abstract Background The decision on diagnostic testing for dementia in general practice should be guided by patients’ preferences. To improve shared decision-making (SDM), a web-based patient decision aid (PtDA) was developed. This study aims to provide insights into the PtDA’s early uptake and first impressions after its’ online launch. Methods The following data were collected: (1) post-PtDA survey and semi-structured interviews with online users, (2) web metrics of the PtDA, (3) uptake numbers in selected general practices, (4) semi-structured interviews with general practitioners (GPs) and practice nurses. Early implementation outcomes (acceptability, adoption, appropriateness, and feasibility) were used to guide data collection and analysis. Quantitative data were analysed using descriptive statistics. Qualitative data were analysed using content analysis. Results Online users, GPs, and practice nurses were predominantly positive about the PtDA’s user-friendliness and its ability to enhance patient autonomy and preference deliberation. In the five months after its launch, 1980 users completed the PtDA. However, uptake in general practices (n = 20) was modest (45%) and online use seemed to decrease over time. The PtDA’s adoption in general practice depended on GPs’ perceived necessity of using the PtDA and/or SDM. For GPs, the PtDA’s perceived appropriateness depended on patient characteristics such as age, health status and awareness of cognitive impairment. GPs and practice nurses expressed diverse approaches to using the PtDA and barriers in time, skills, and practical issues related to its’ (early) feasibility. Conclusions While the PtDA’s early uptake and first impressions are generally positive, our findings highlight the need for a targeted implementation strategy for use in daily general practice in addition to the PtDA’s integration into a well-known and widely-used medical information website.