title: Decision coaching to prepare patients for making health decisions: a systematic review of decision coaching in trials of patient decision AIDS.
abstract: Decision coaching is individualized, nondirective facilitation of patient preparation for shared decision making.
  
  
  
  To explore characteristics and effectiveness of decision coaching evaluated within trials of patient decision aids (PtDAs) for health decisions.
  
  
  
  A subanalysis of trials included in the 2011 Cochrane Review of PtDAs.
  
  
  
  Eligible trials allowed the effectiveness of decision coaching to be compared with another intervention and/or usual care.
  
  
  
  Two reviewers independently screened 86 trials, extracted data, and appraised quality.
  
  
  
  Ten trials were eligible. Decision coaching was provided by genetic counselors, nurses, pharmacists, physicians, psychologists, or health educators. Coaching compared with usual care (n = 1 trial) improved knowledge. Coaching plus PtDA compared with usual care (n = 4) improved knowledge and participation in decision making without reported dissatisfaction. Coaching compared with PtDA alone (n = 4) increased values-choice agreement and improved satisfaction with the decision-making process without any difference in knowledge or participation in decision making. Coaching plus PtDA compared with PtDA alone (n = 4) had no difference in knowledge, values-choice agreement, participation in decision making, or satisfaction with the process. Decision coaching plus PtDA was more cost-effective compared with PtDA alone or usual care (n = 1).
  
  
  
  Methodological quality, number of trials, and description of decision coaching.
  
  
  
  Compared with usual care, decision coaching improved knowledge. However, the improvement in knowledge was similar when coaching was compared with PtDA alone. Outcomes for other comparisons are more variable, some trials showing positive effects and other trials reporting no difference. Given the small number of trials and variability in results, further research is required to determine the effectiveness of decision coaching.
authors.affiliation: University of Ottawa, Ottawa, Canada (DS)|Ottawa Hospital Research Institute, Ottawa, Canada (DS, CB, MAM, SM)
authors.forename: Dawn
authors.initials: D
authors.lastname: Stacey
authors.affiliation: University of Saskatchewan, Saskatoon, Canada (JK)
authors.forename: Jennifer
authors.initials: J
authors.lastname: Kryworuchko
authors.affiliation: Ottawa Hospital Research Institute, Ottawa, Canada (DS, CB, MAM, SM)
authors.forename: Carol
authors.initials: C
authors.lastname: Bennett
authors.affiliation: Ottawa Hospital Research Institute, Ottawa, Canada (DS, CB, MAM, SM)|The Ottawa Hospital, Ottawa, Canada (MAM)
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Murray
authors.affiliation: Ottawa Hospital Research Institute, Ottawa, Canada (DS, CB, MAM, SM)
authors.forename: Sarah
authors.initials: S
authors.lastname: Mullan
authors.affiliation: Centre Hospitalier Universitaire de Que´ bec Research Center, Que´ bec, Canada (FL)
authors.forename: France
authors.initials: F
authors.lastname: Légaré
mesh_terms: D002170:Canada; D003142:Communication; D003657:Decision Making; D003661:Decision Support Techniques; D037001:Directive Counseling; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000193:education; D006801:Humans; D020407:Internet; D008960:Models, Psychological; D010353:Patient Education as Topic / Q000379:methods*; D011369:Professional-Patient Relations; D014741:Video Recording; D016526:Workload