Development of a patient decision aid on inhaled corticosteroids use for adults with asthma.
Patient decision aids (PDAs) are used in shared decision making to improve practitioner-patient communication and help patients decide about treatment options. To develop a PDA for adults with asthma considering inhaled corticosteroids, with or without long-acting beta2-agonists, to optimize asthma control.



The PDA was developed based on the International Patient Decision Aid Standards. Step 1: PDA was drafted. Step 2: PDA acceptability was assessed among target users, certified asthma educators (CAEs) and adults with asthma, following an iterative process. a) Participants read the PDA, b) rated its presentation, length, balance, and perceived usefulness, indicated what they liked/disliked about it, and made suggestions for improvement. c) Based on results from (b), PDA was refined. This process was repeated with new participants until no suggestions were made. Step 3: The PDA was field tested with target users. Interviews with CAEs were conducted to identify areas of improvement. Step 4: Final PDA version was written.



A color-printed, 4-page, letter-sized PDA was drafted. Acceptability testing involved 11 CAEs (women, n = 10) and 20 adults with asthma (women, n = 13; age 22-61 years). Five successive refined versions were produced. Major changes were made to PDA terminology, instructions, paper size, and visual presentation. Two CAEs (women, n = 2) and 26 adults with asthma (women, n = 19; age 20-65 years) field tested PDA. Minor changes were made to language and instructions to ensure usability. The final version was a color-printed, 12-page, A3-sized booklet.



Our newly developed PDA was found acceptable and usable in target users.
a Knowledge Translation , Education and Prevention Chair in Respiratory and Cardiovascular Health, Laval University , Quebec City , Quebec , Canada.|b Quebec Heart and Lung Institute , Quebec City , Quebec , Canada.
Myriam E
ME
Gagné
c Canada Research Chair in Implementation of Shared Decision Making in Primary Care , Laval University , Quebec City , Quebec , Canada.|d CHU de Québec Research Center , Population Health and Optimal Health Practices Research Unit , Quebec City , Quebec , Canada.|e Faculty of Medicine , Laval University , Quebec City , Quebec , Canada.
France
F
Légaré
d CHU de Québec Research Center , Population Health and Optimal Health Practices Research Unit , Quebec City , Quebec , Canada.|f Chair on Adherence to Treatments , Laval University , Quebec City , Quebec , Canada.|g Faculty of Pharmacy , Laval University , Quebec City , Quebec , Canada.
Jocelyne
J
Moisan
a Knowledge Translation , Education and Prevention Chair in Respiratory and Cardiovascular Health, Laval University , Quebec City , Quebec , Canada.|b Quebec Heart and Lung Institute , Quebec City , Quebec , Canada.|e Faculty of Medicine , Laval University , Quebec City , Quebec , Canada.
Louis-Philippe
LP
Boulet
D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D058666:Adrenergic beta-2 Receptor Agonists / Q000627:therapeutic use; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy*; D003657:Decision Making; D003661:Decision Support Techniques; D004359:Drug Therapy, Combination; D006801:Humans
D000305:Adrenal Cortex Hormones; D058666:Adrenergic beta-2 Receptor Agonists; D018927:Anti-Asthmatic Agents
Asthma; decision support; inhaled controller medication; inhaled corticosteroids; respiratory disease; shared decision making