Collaborative design of a decision aid for stroke survivors with multimorbidity: a qualitative study in the UK engaging key stakeholders
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Objectives: Effective secondary stroke prevention strategies are sub-optimally used. Novel
development of interventions to enable healthcare professionals and stroke survivors to manage risk
factors for stroke recurrence are required. We sought to engage key stakeholders in the design and
evaluation of an intervention informed by a Learning Health System approach, to improve risk factor
management and secondary prevention for stroke survivors with multimorbidity.
Design: Qualitative, including focus groups, semi-structured interviews and usability evaluations. Data
was audio-recorded, transcribed and coded thematically.
Participants: Stroke survivors, carers, health and social care professionals, commissioners, policy
makers and researchers.
Setting: Stroke survivors were recruited from the South London Stroke Register; health and social care
professionals through South London general practices and King’s College London (KCL) networks;
carers, commissioners, policy-makers and researchers through KCL networks.
Results: 53 stakeholders in total participated in focus groups, interviews and usability evaluations.
Thirty-seven participated in focus groups and interviews, including stroke survivors and carers (N=11),
health and social care professionals (N=16), commissioners and policy-makers (N=6) and researchers
(N=4). Sixteen participated in usability evaluations, including stroke survivors (N=8) and general
practitioners (GPs; N=8). Eight themes informed the collaborative design of DOTT (Deciding on
Treatments Together), a decision aid integrated with the electronic health record system, to be used
in primary care during clinical consultations between the healthcare professional and stroke survivor.
DOTT aims to facilitate shared decision making on personalised treatments leading to improved
treatment adherence and risk control. DOTT was found acceptable and usable among stroke survivors
and GPs during a series of evaluations.
Conclusions: Adopting a user-centred data-driven design approach informed an intervention that is
acceptable to users and has the potential to improve patient outcomes. A future feasibility study and
subsequent clinical trial will provide evidence of the effectiveness of DOTT in reducing risk of stroke
recurrence.
development of interventions to enable healthcare professionals and stroke survivors to manage risk
factors for stroke recurrence are required. We sought to engage key stakeholders in the design and
evaluation of an intervention informed by a Learning Health System approach, to improve risk factor
management and secondary prevention for stroke survivors with multimorbidity.
Design: Qualitative, including focus groups, semi-structured interviews and usability evaluations. Data
was audio-recorded, transcribed and coded thematically.
Participants: Stroke survivors, carers, health and social care professionals, commissioners, policy
makers and researchers.
Setting: Stroke survivors were recruited from the South London Stroke Register; health and social care
professionals through South London general practices and King’s College London (KCL) networks;
carers, commissioners, policy-makers and researchers through KCL networks.
Results: 53 stakeholders in total participated in focus groups, interviews and usability evaluations.
Thirty-seven participated in focus groups and interviews, including stroke survivors and carers (N=11),
health and social care professionals (N=16), commissioners and policy-makers (N=6) and researchers
(N=4). Sixteen participated in usability evaluations, including stroke survivors (N=8) and general
practitioners (GPs; N=8). Eight themes informed the collaborative design of DOTT (Deciding on
Treatments Together), a decision aid integrated with the electronic health record system, to be used
in primary care during clinical consultations between the healthcare professional and stroke survivor.
DOTT aims to facilitate shared decision making on personalised treatments leading to improved
treatment adherence and risk control. DOTT was found acceptable and usable among stroke survivors
and GPs during a series of evaluations.
Conclusions: Adopting a user-centred data-driven design approach informed an intervention that is
acceptable to users and has the potential to improve patient outcomes. A future feasibility study and
subsequent clinical trial will provide evidence of the effectiveness of DOTT in reducing risk of stroke
recurrence.
Date Issued
2019-08-15
Date Acceptance
2019-07-01
Citation
BMJ Open, 9 (8)
ISSN
2044-6055
Publisher
BMJ Journals
Journal / Book Title
BMJ Open
Volume
9
Issue
8
Copyright Statement
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.
This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
Subjects
Decision Support System
Learning Health System
Primary Care
Shared Decision Making
Stakeholder Engagment
Stroke Medicine
1103 Clinical Sciences
1117 Public Health and Health Services
1199 Other Medical and Health Sciences
Publication Status
Published online
Article Number
e030385
Date Publish Online
2019-08-15