The perspectives of Iranian physicians and patients towards patient decision aids: a qualitative study.
BACKGROUND
Patient preference is one of the main components of clinical decision making, therefore leading to the development of patient decision aids. The goal of this study was to describe physicians' and patients' viewpoints on the barriers and limitations of using patient decision aids in Iran, their proposed solutions, and, the benefits of using these tools.


METHODS
This qualitative study was conducted in 2011 in Iran by holding in-depth interviews with 14 physicians and 8 arthritis patient. Interviewees were selected through purposeful and maximum variation sampling. As an example, a patient decision aid on the treatment of knee arthritis was developed upon literature reviews and gathering expert opinion, and was presented at the time of interview. Thematic analysis was conducted to analyze the data by using the OpenCode software.


RESULTS
The results were summarized into three categories and ten codes. The extracted categories were the perceived benefits of using the tools, as well as the patient-related and physician-related barriers in using decision aids. The following barriers in using patient decision aids were identified in this study: lack of patients and physicians' trainings in shared decision making, lack of specialist per capita, low treatment tariffs and lack of an exact evaluation system for patient participation in decision making.


CONCLUSIONS
No doubt these barriers demand the health authorities' special attention. Hence, despite patients and physicians' inclination toward using patient decision aids, these problems have hindered the practical usage of these tools in Iran--as a developing country.
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. nejatsan@tums.ac.ir.
Hamideh
H
Rashidian
Saharnaz
S
Nedjat
Reza
R
Majdzadeh
Jaleh
J
Gholami
Leila
L
Haghjou
Bahar Sadeghi
BS
Abdollahi
Fereydoun
F
Davatchi
Arash
A
Rashidian
D001291:Attitude of Health Personnel; D003469:Culture; D003657:Decision Making; D003661:Decision Support Techniques; D004992:Ethics, Medical; D005260:Female; D005500:Follow-Up Studies; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006801:Humans; D007492:Iran; D008297:Male; D010358:Patient Participation / Q000706:statistics & numerical data*; D028701:Patient Rights; D010817:Physician-Patient Relations; D010820:Physicians / Q000706:statistics & numerical data*; D036301:Qualitative Research