Vanesa Ramos García, Amado Rivero Santana, Wenceslao Peñate Castro, Yolanda Álvarez Pérez, María del Mar Trujillo Martín, Himar González Pacheco, Anthea Santos Álvarez, Andrea Duarte Díaz, María Isabel Del Cura González, Lilisbeth Perestelo Pérez
ABSTRACT
Objective
To evaluate the effectiveness of an online Patient Decision Aid (PtDA) for patients with Generalised Anxiety Disorder (GAD).
Design
Randomised controlled trial comparing the PtDA to general information (fact sheet).
Setting
The study took place in 17 primary care centres in the Canary Islands (Spain).
Participants
Patients diagnosed with GAD and a score ≥8 in the GAD-7 questionnaire.
Intervention
Patients were randomly allocated to the PtDA group (n=58) or the control group (n=61).
Main outcome measure
The primary outcome was decisional conflict at postintervention, assessed with the Decisional Conflict Scale (DCS). Secondary outcomes include knowledge about GAD and its treatments, concordance between informed preference and 3 month actual choice, decision quality and GAD symptoms.
Results
There were no significant differences in decisional conflict at postintervention or 3 month follow-up in the intention-to-treat (ITT) or per-protocol sample (PPS). The PtDA significantly improved postintervention (MD=1.65, 95% CI: 0.84 to 2.46) and 3 month objective knowledge (MD=0.78, 95% CI: 0.02 to 1.55). In the PPS, anxiety symptoms at 3 months were significantly lower in the PtDA group (MD=−3.00, 95% CI: −5.69 to –0.30), but in the ITT sample, this difference did not reach significance (p=0.06). There were no significant differences in the rate of patients unsure about treatment preference at postintervention, nor on concordance or decision quality at follow-up.
Conclusion
The use of the PtDA led to improvements in knowledge at 3 months, but it did not result in a significant reduction of decisional conflict. These results must be interpreted with caution, given the methodological limitations of the study, mainly the high rate of dropouts. Further research is needed to confirm these results, the first published on the effectiveness of a PtDA for GAD patients.
Trial registration number NCT04364958.
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