Decision aids are tools that can be used to involve patients in decisions about their treatment. Enhanced patient involvement is important as effective physician-patient communication can affect health outcomes such as emotional health and symptom resolution.¹ In hypertension, patient involvement is particularly important as the decision not to take medication may have adverse future clinical consequences, yet the medicine will need to be taken over a time when the patient is likely to be asymptomatic.

The aim of this study was to explore newly diagnosed hypertensive patients' views on the usefulness of a computerised decision aid aimed at facilitating their decision-making about whether or not to take anti-hypertensive medication. The decision aid was a 40-minute computer programme which incorporated individualised values regarding drug treatment with the patient's cardiovascular risk factors from the Framingham risk equation. This information was used to determine an individualised patient value as to whether or not the patient should begin anti-hypertensive treatment. This study will report the findings from the follow-up interviews with a group of patients who completed this computerised decision aid.

Semi-structured interviews were conducted with 15 patients 1-14 days after using the computerised decision aid. The interviews lasted between 20 and 40 minutes. The interviews explored the patient's initial attitude to taking medication, the ease of use of the decision aid, the helpfulness of the decision aid in their decision making and their views on the usefulness of the decision aid as a stand alone tool for future use in a general practice surgery.

Analysis of the findings is currently in progress. Patients were aged between 47 and 69. Eight of the respondents were male. Preliminary findings suggest that most of the patients enjoyed using the decision aid, with a few offering suggestions as to how it could be improved. Whether patients liked the decision aid because it provided information or because they found the decision analytic process itself useful was more difficult to determine. Most felt it would be useful in a general practice surgery but that the elderly in particular, unfamiliar with computer use, may find it difficult. A minority of patients had difficulty understanding the standard gamble process. Several patients changed their mind about their willingness to take tablets after using the decision aid. For some, the increase in information provided by the decision aid made them more aware of the need to take tablets. For others, it made them more confident in their assertion not to take tablets due to their low cardiovascular risk.

In conclusion, most patients found the decision aid easy to use and welcomed this method as an opportunity to obtain more information about their condition.

References

1. Stewart M. Effective physician-patient communication and health outcomes: a review. Can Med Assoc J 1995; 152: 1423-33.