Evaluation of the implementation of patient decision aid: A mixed-method study

Abstract

Abstract Background This study aimed to evaluate the implementation of an insulin-choice PDA specifically measuring implementation outcomes.Methods A mixed-methods sequential explanatory design was used. The RE-AIM domains namely “Reach”, “Adoption”, “Implementation”, and “Maintenance” were used to guide evaluation.Results For ‘Reach’, 88.9% (n = 48/54) of doctors and 55% (n = 11/20) of nurses attended the insulin PDA training workshops. This was attributed to their self-motivation and the mandate from the Head of Department. The PDA reached 387 patients and was facilitated by the doctors who delivered the PDA to them and their own desire to know more about insulin. Doctors’ ‘Adoption’ of the PDA was high (83.3%, n = 45/54) due to the positive personal experience with the usefulness of the PDA. Only 65.7% (n = 94/143) of patients who received the PDA read it. The degree of ‘Implementation’ of the PDA varied for different tasks (ranged from 19.2%-84.9%) and was challenged by patient and system barriers. For ‘Maintenance’, 80% of the doctors were willing to continue using the PDA due to its benefits.Conclusion This study highlighted that PDA implementation is promising. Addressing the issues of social hierarchy, and HCPs’ roles and responsibilities can further improve implementation outcomes.