TY - JOUR
T1 - Patients' and health professionals' views on shared decision-making in age-related macular degeneration care
T2 - A qualitative study
AU - Scheffer, Mariska
AU - Menting, Juliane
AU - Roodbeen, Ruud
AU - van Dulmen, Sandra
AU - van Hecke, Manon
AU - Schlingemann, Reinier
AU - van Nispen, Ruth
AU - Boeije, Hennie
N1 - Funding Information: This study was financed by the Dutch National Health Care Institute Publisher Copyright: © 2022 College of Optometrists.
PY - 2022/9/1
Y1 - 2022/9/1
N2 - Background: Age-related macular degeneration (AMD) is one of the principal causes of irreversible visual impairment in the older adult population. Recent evidence indicates that there are signs of undertreatment and overtreatment, underdiagnosis and insufficient information provision in AMD care. Shared decision-making (SDM) can aid information sharing between patients and health professionals and enhances high-quality care. This research aimed to gain insight into patients' and professionals' views on SDM in AMD care. Methods: Semi-structured interviews were conducted with 20 patients with AMD and 19 health professionals in June and July 2020. Participants were recruited through hospitals, professional and patient associations and (social) networks. Sample representativeness was ensured in terms of sociodemographic and disease characteristics for patients, and profession-related characteristics for health professionals. Interviews were analysed according to a predetermined coding framework. Results: Although SDM is receiving attention in AMD care, health professionals and patients experienced barriers in making shared decisions. The most common barriers reported included limitations in treatment options, time constraints, strict treatment guidelines and patients' comorbidity. Furthermore, most patients indicated that they were not (fully) informed about all aspects of AMD trajectory, such as the possibility to discontinue therapy or the long-term and invasive character of treatment. Some patients expressed the need for a more empathic and person-centred communication style from their health professional. Conclusion: The concerns raised by patients and health professionals suggest that there is room for improvement in delivery of SDM in AMD care. Findings from this study indicate that information provision and communication can be improved.
AB - Background: Age-related macular degeneration (AMD) is one of the principal causes of irreversible visual impairment in the older adult population. Recent evidence indicates that there are signs of undertreatment and overtreatment, underdiagnosis and insufficient information provision in AMD care. Shared decision-making (SDM) can aid information sharing between patients and health professionals and enhances high-quality care. This research aimed to gain insight into patients' and professionals' views on SDM in AMD care. Methods: Semi-structured interviews were conducted with 20 patients with AMD and 19 health professionals in June and July 2020. Participants were recruited through hospitals, professional and patient associations and (social) networks. Sample representativeness was ensured in terms of sociodemographic and disease characteristics for patients, and profession-related characteristics for health professionals. Interviews were analysed according to a predetermined coding framework. Results: Although SDM is receiving attention in AMD care, health professionals and patients experienced barriers in making shared decisions. The most common barriers reported included limitations in treatment options, time constraints, strict treatment guidelines and patients' comorbidity. Furthermore, most patients indicated that they were not (fully) informed about all aspects of AMD trajectory, such as the possibility to discontinue therapy or the long-term and invasive character of treatment. Some patients expressed the need for a more empathic and person-centred communication style from their health professional. Conclusion: The concerns raised by patients and health professionals suggest that there is room for improvement in delivery of SDM in AMD care. Findings from this study indicate that information provision and communication can be improved.
KW - age-related macular degeneration
KW - communication
KW - information provision
KW - shared decision-making
KW - visual impairment
UR - http://www.scopus.com/inward/record.url?scp=85131787318&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/opo.13016
DO - https://doi.org/10.1111/opo.13016
M3 - Article
C2 - 35938211
SN - 0275-5408
VL - 42
SP - 1015
EP - 1022
JO - Ophthalmic & physiological optics
JF - Ophthalmic & physiological optics
IS - 5
ER -