title: The development of a personalized patient education tool for decision making for postmenopausal women with osteoporosis.
abstract: A personalized patient education tool for decision making (PET) for postmenopausal women with osteoporosis was developed by means of a systematic development approach. A prototype was constructed and refined by involving various professionals and patients. Professionals and patients expressed a positive attitude towards the use of the PET.
  
  
  
  The purpose was to systematically develop a paper-based personalized PET to assist postmenopausal women with osteoporosis in selecting a treatment in line with their personal values and preferences.
  
  
  
  The development of the PET was based on a systematic process including scope, design, development of a prototype, and alpha testing among professionals and patients by semi-structured interviews.
  
  
  
  The design and development resulted in a four-page PET prototype together with a one-page fact sheet of the different drug options. The prototype PET provided the personal risk factors, the estimated individualized risk for a future major osteoporotic fracture and potential reduction with drugs, and a summary of advantages and disadvantages whether or not to start drugs. The drug fact sheet presents five attributes of seven drugs in a tabular format. The alpha testing with professionals resulted in some adaptations, e.g., inclusion of the possibility to calculate fracture risk based on various individual risk scoring methods. Important results from the alpha testing with patients were differences in the fracture risk percentage which was seen as worthwhile to start drugs, the importance of an overview of side effects, and of the timing of the PET into the patient pathway. All women indicated that the PET could be helpful for their decision to select a treatment.
  
  
  
  Physicians and patients expressed a positive attitude towards the use of the proposed PET. Further research would be needed to test the effects of the PET on feasibility in clinical workflow and on patient outcomes.
authors.affiliation: Department of Health Services Research, School for Public Health and Primary Care (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands. m.hiligsmann@maastrichtuniversity.nl.
authors.forename: M
authors.initials: M
authors.lastname: Hiligsmann
authors.affiliation: Department of Family Medicine, CAPHRI, Maastricht University, Maastricht, The Netherlands.
authors.forename: G
authors.initials: G
authors.lastname: Ronda
authors.affiliation: Department of Family Medicine, CAPHRI, Maastricht University, Maastricht, The Netherlands.
authors.forename: T
authors.initials: T
authors.lastname: van der Weijden
authors.affiliation: Department of Internal Medicine, CAPHRI, Maastricht University, Maastricht, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Boonen
mesh_terms: D003657:Decision Making; D005260:Female; D006801:Humans; D015663:Osteoporosis, Postmenopausal / Q000628:therapy*; D058866:Osteoporotic Fractures / Q000517:prevention & control; D010353:Patient Education as Topic; D017698:Postmenopause
keywords: Decision aid; Osteoporosis; Patient; Patient educational tool; Shared decision making