Clinicians' views on a patient decision aid for deep brain stimulation in Parkinson's disease.

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IntroductionFor people with Parkinson's disease (PD), deciding whether to pursue deep brain stimulation (DBS) has become increasingly complex. Evidence suggests current approaches to collaborative decision-making may fall short of accepted standards. Thus, a decision support intervention, such as a patient decision aid (PtDA) may be warranted. PtDAs have been shown to improve patients' knowledge, expectations, and participation in decision-making for other, similar healthcare decisions. We therefore sought to assess neurologists' awareness of, and experience using, PtDAs, and to solicit their opinions on the ideal features of a PtDA for PD patients considering DBS.MethodsSixteen United States-based neurology clinicians were interviewed about their experiences in treating and counseling PD patients considering DBS. These semi-structured interviews were analyzed using qualitative content analysis.ResultsSeven general neurologists, eight movement disorders specialists, and one registered nurse in a movement practice participated in interviews. None of the clinicians had experience using a patient decision aid, and many were unfamiliar with the concept altogether. All largely expressed optimism about the potential utility of a PtDA for PD patients considering DBS. There was less consensus about the ideal format, content, and implementation of such a PtDA.ConclusionHealthcare providers recognize the potential benefits of a PtDA to engage PD patients considering DBS. However, input from other stakeholders-particularly the patients themselves-is essential to validate these findings.

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