title: The impact of DECISION+2 on patient intention to engage in shared decision making: secondary analysis of a multicentre clustered randomized trial.
abstract: BACKGROUND
  Training health professionals in shared decision making (SDM) may influence their patients' intention to engage in SDM.
  
  
  OBJECTIVE
  To assess the impact of DECISION+2, a SDM training programme for family physicians about the use of antibiotics to treat acute respiratory infections (ARIs), on their patients' intention to engage in SDM in future consultations.
  
  
  METHODS
  Secondary analysis of a multicentre clustered randomized trial.
  
  
  METHODS
  Three hundred and fifty-nine patients consulting family physicians about an ARI in nine family practice teaching units (FPTUs).
  
  
  METHODS
  DECISION+2 (two-hour online tutorial, two-hour workshop, and decision support tools) was offered in the experimental group (five FPTUs, 162 physicians, 181 patients). Usual care was provided in the control group (four FPTUs, 108 physicians, 178 patients).
  
  
  METHODS
  Change in patients' intention scores (range -3 to +3) between pre- and post-consultation.
  
  
  RESULTS
  The mean ± SD [median] scores of intention to engage in SDM were high in both study groups before consultation (DECISION+2 group: 1.4 ± 1.0 [1.7]; control group: 1.5 ± 1.1 [1.7]) and increased in both groups after consultation (DECISION+2 group: 2.1 ± 1.1 [2.7]; control group: 1.9 ± 1.2 [2.3]). Change of intention, classified as either increased, stable or decreased, was not statistically associated with the exposure to the DECISION+2 programme after adjusting for the cluster design (proportional odds ratio = 1.5; 95% confidence interval = 0.8-3.0).
  
  
  CONCLUSIONS
  DECISION+2 had no significant impact on patients' intention to engage in SDM for choosing to use antibiotics or not to treat an ARI in future consultations. Patient-targeted interventions may be necessary to achieve this purpose.
authors.affiliation: Department of Social and Preventive Medicine, Université Laval, Quebec City, QC, Canada.|Research Center of the Centre Hospitalier Universitaire de Quebec, Hôpital St-François-D'Assise, Quebec City, QC, Canada.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Couët
authors.affiliation: Department of Family Medicine and Emergency Medicine, Université Laval, Quebec City, QC, Canada.|Research Center of the Centre Hospitalier Universitaire de Quebec, Hôpital St-François-D'Assise, Quebec City, QC, Canada.
authors.forename: Michel
authors.initials: M
authors.lastname: Labrecque
authors.affiliation: Research Center of the Centre Hospitalier Universitaire de Quebec, Hôpital St-François-D'Assise, Quebec City, QC, Canada.
authors.forename: Hubert
authors.initials: H
authors.lastname: Robitaille
authors.affiliation: Research Center of the Centre Hospitalier Universitaire de Quebec, Hôpital St-François-D'Assise, Quebec City, QC, Canada.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Turcotte
authors.affiliation: Department of Family Medicine and Emergency Medicine, Université Laval, Quebec City, QC, Canada.|Research Center of the Centre Hospitalier Universitaire de Quebec, Hôpital St-François-D'Assise, Quebec City, QC, Canada.|Canada Research Chair in Implementation of Shared Decision Making in Primary Care, QC, Canada.
authors.forename: France
authors.initials: F
authors.lastname: Légaré
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003657:Decision Making; D004493:Education; D005260:Female; D006801:Humans; D033182:Intention; D008297:Male; D010821:Physicians, Family / Q000193:education; D012141:Respiratory Tract Infections / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents
keywords: clinician-patient communication; implementation; patient involvement in decision making; shared decision making; theory of planned behaviour