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

Abstract

Introduction For 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. Methods Sixteen 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. Results Seven 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. Conclusion Healthcare 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.