IN a new multicenter study, researchers found that the effectiveness of a computerized patient decision aid (PtDA) for systemic lupus erythematosus (SLE) hinges not on where or how it is used but on whether patients view it fully and without interruptions.
The study evaluated 813 patients with SLE across 15 rheumatology clinics, examining whether the decision aid’s delivery setting, in-clinic versus at-home telemedicine, or modality-touchpad, smartphone, or computer-affected shared decision-making (SDM) and patient-reported outcomes. Participants completed validated scales assessing decision conflict (DCS), preparation for decision-making (PDM), and overall satisfaction with the tool.
Findings showed that neither the setting nor the delivery method significantly influenced SDM outcomes. However, patients who experienced interruptions while viewing the PtDA reported lower scores in feasibility, acceptability, and preparation for decision-making. Similarly, incomplete viewing was linked to poorer scores in both the PDM and DCS metrics.
These insights suggest that while digital flexibility in delivering decision aids offers convenience, the conditions under which they are consumed play a crucial role in their effectiveness. Specifically, uninterrupted and complete engagement with the SLE PtDA is essential to fully realize its benefits in supporting patient-centered care.
This study adds to the growing body of evidence on how implementation logistics can affect digital health tool performance. As healthcare systems continue to expand telehealth and remote care options, optimizing the environment in which patients interact with decision aids may be just as important as the content of the tools themselves.
Reference:
Singh JA et al. Where, how, and how much? A multicenter cohort study of the relationship between lupus decision aid modality, place of administration, interruption and viewing completeness and patient-reported outcomes. Arthritis Care Res (Hoboken). 2025. doi: 10.1002/acr.25603. [Online ahead of print]
