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Journal Articles BMJ Open Year : 2017

Decisional needs assessment of patients with complex care needs in primary care: a participatory systematic mixed studies review protocol

Mathieu Bujold
  • Function : Author
Pierre Pluye
  • Function : Author
Jeannie Haggerty
  • Function : Author
Genevieve C Gore
  • Function : Author
Reem El Sherif
  • Function : Author
Marie-Eve Poitras
  • Function : Author
Marie-Claude Beaulieu
  • Function : Author
Marie-Dominique Beaulieu
  • Function : Author
Paula L. Bush
  • Function : Author
Beatrice Débarges
  • Function : Author
Justin Gagnon
  • Function : Author
Anik Giguère
  • Function : Author
Roland Grad
  • Function : Author
Vera Granikov
  • Function : Author
Serge Goulet
  • Function : Author
Catherine Hudon
  • Function : Author
Bernardo Kremer
  • Function : Author
Edeltraut Kröger
  • Function : Author
Irina Kudrina
  • Function : Author
Christine Loignon
  • Function : Author
Marie-Therese Lussier
  • Function : Author
Cristiano Martello
  • Function : Author
Quynh Nguyen
  • Function : Author
Rebekah Pratt
  • Function : Author
Benoit Rihoux
  • Function : Author
Ellen Rosenberg
  • Function : Author
Isabelle Samson
  • Function : Author
Nicolas Senn
David Li Tang
  • Function : Author
Masashi Tsujimoto
  • Function : Author
Isabelle Vedel
  • Function : Author
Michel Wensing
  • Function : Author

Abstract

Introduction Patients with complex care needs (PCCNs) often suffer from combinations of multiple chronic conditions, mental health problems, drug interactions and social vulnerability, which can lead to healthcare services overuse, underuse or misuse. Typically, PCCNs face interactional issues and unmet decisional needs regarding possible options in a cascade of interrelated decisions involving different stakeholders (themselves, their families, their caregivers, their healthcare practitioners). Gaps in knowledge, values clarification and social support in situations where options need to be deliberated hamper effective decision support interventions. This review aims to (1) assess decisional needs of PCCNs from the perspective of stakeholders, (2) build a taxonomy of these decisional needs and (3) prioritise decisional needs with knowledge users (clinicians, patients and managers). Methods and analysis This review will be based on the interprofessional shared decision making (IP-SDM) model and the Ottawa Decision Support Framework. Applying a participatory research approach, we will identify potentially relevant studies through a comprehensive literature search; select relevant ones using eligibility criteria inspired from our previous scoping review on PCCNs; appraise quality using the Mixed Methods Appraisal Tool; conduct a three-step synthesis (sequential exploratory mixed methods design) to build taxonomy of key decisional needs; and integrate these results with those of a parallel PCCNs’ qualitative decisional need assessment (semistructured interviews and focus group with stakeholders). Ethics and dissemination This systematic review, together with the qualitative study (approved by the Centre Intégré Universitaire de Santé et Service Sociaux du Saguenay-Lac-Saint-Jean ethical committee), will produce a working taxonomy of key decisional needs (ontological contribution), to inform the subsequent user-centred design of a support tool for addressing PCCNs’ decisional needs (practical contribution). We will adapt the IP-SDM model, normally dealing with a single decision, for PCCNs who experience cascade of decisions involving different stakeholders (theoretical contribution). Knowledge users will facilitate dissemination of the results in the Canadian primary care network. PROSPERO registration number CRD42015020558.

Dates and versions

hal-01682988 , version 1 (12-01-2018)

Identifiers

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Mathieu Bujold, Pierre Pluye, France Legare, Jeannie Haggerty, Genevieve C Gore, et al.. Decisional needs assessment of patients with complex care needs in primary care: a participatory systematic mixed studies review protocol. BMJ Open, 2017, 7 (11), pp.e016400. ⟨10.1136/bmjopen-2017-016400⟩. ⟨hal-01682988⟩
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