Applicability of decision aids in emergency departments: an exploratory review
e201911109
Keywords:
Decision making, Decision support techniques, Emergency medical services, Quality of health careAbstract
Background: Decision aid tools (DAT) have been widely used in chronic diseases, but there are few studies on their usefulness in emergency departments. The objective of this study was to analyse the applicability of DAT in emergency services.
Methods: An exploratory review was conducted. Between January 1, 2012 and August 1, 2019, searches of randomised and controlled clinical trials, systematic reviews and other secondary studies where DAT are used to assist patients of any age in emergency services were conducted. The databases used were: Pubmed, Embase, Web Of Science, Cuiden, Patient Decision Aids Research Group IPDAS Collaboration, Cochrane, Centres for Reviews and Dissemination, National Guideline Clearinghouse, Guidelines International Network. Two reviewers analysed and selected the studies.
Results: Twelve studies of moderate-low quality were included. The patients in the intervention group (IG) were more aware of their illness (X=3.6 vs 3 correct answers and X=4.2 vs 3.6), and more involved in the decisions (score in OPTION: 26.6 vs 7 and 18.3 vs 7). The conflict was reduced in the IG regarding those imaging tests in the TBI (traumatic brain injury; X=14.8 vs 19.2). In the IG, admittance to perform effort tests was reduced in low-risk chest pain (58% vs 77%; CI95%=6%-31%, 37% vs 52%; p<0.001). When DAT were used in children with diarrhoea or vomiting, in 80% of the cases the decision was to use oral rehydration against 61% in the control group (CG, p=0.001).
Conclusions: DAT in emergency services improve patient’s knowledge about the disease and their participation in care. More studies are needed to develop DAT in emergency services.
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Copyright (c) 2019 Valle Coronado-Vázquez, Yolanda Navarro-Abal, Rosa Magallón-Botaya, Javier Cerezo Espinosa de los Monteros, Óscar Cruz-Salgado, Juan Gómez-Salgado, Mª del Valle Ramírez Durán
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