Development of a decision support tool for patients with Crohn's disease considering biologic treatment

Abstract

The study aimed to develop a decision support tool for patients with Crohn's disease considering biologic treatment and evaluate its usability, validity, and acceptability. A prototype was systematically developed based on the Ottawa Decision Support Framework. The prototype met all the qualifying criteria of the International Patient Decision Aid Standards instrument. A questionnaire survey was designed to assess the prototype, with 22 patients and six clinicians recruited. We calculated the descriptive statistics for the survey data and analyzed the free responses using a qualitative content analysis and the prototype features requiring refinement extraction. The survey was completed by 18 patients and six clinicians. The prototype was assessed as "very useful" by 66.7% of the patients and clinicians and "quite useful" by 33.3%. The information that patients must know was considered to be "well represented" by the prototype, as expressed by 72.2% of the patients and 66.7% of the clinicians, and as "somewhat represented," as expressed by 27.8 and 33.3%, respectively. Most respondents reported that the content was "easy to understand" (patients: 83.3%; clinicians: 100%); the format was "easy to use" (patients: 77.8%; clinicians: 100%); and the information presentation was "well-balanced" (patients: 83.3%; clinicians: 100%). The patients suggested improvements, such as using figures to make the text concise and revising the checklist format and content to facilitate decision making. We created an evidence-based decision support tool after modifying the prototype according to the survey results. Further investigation of the tool effectiveness for Crohn's disease patients considering biologic treatment is needed.