Feasibility of a shared decision-making intervention for individuals with COPD considering Pulmonary Rehabilitation

Introduction:

Our intervention was developed to support patients with Chronic Obstructive Pulmonary Disease (COPD) make informed and values-based decisions about PR with healthcare professionals (PRhp) The shared decision making intervention (SDMi) components are a patient decision aid, decision coaching training, and a consultation prompt.

Aim:

To evaluate the feasibility of the SDMi.

Methods:

Convenience sampling was used to recruit patients with COPD referred to a UK PR service between Dec 2021 and Sep 2022. PRhp attended decision coaching training, patients received the decision aid at PR referral, and the PRhp used the consultation prompt during consultations.

Outcomes included recruitment capability, data completeness, and intervention fidelity. Questionnaires assessed patient activation and decisional conflict at baseline and at completion/drop out of PR. Consultations were audio recorded and assessed using the Observer OPTION-5 scale (scores range from 0-100 with higher scores indicating greater adoption of SDM).

Results:

Recruitment rates for patients were 13% (n=31, 32% female) and for PRhp were 100% (n=9, 78% female). Patients had a mean(SD) age 71.2(7.5) and median(IQR) MRC dyspnoea 3.11(1.05)). At follow up, 81% (n=25) patients completed the patient activation and decisional conflict outcomes. SDM elements were present in all consultations; standardised scores ranged from 10.00 to 82.50 (mean(SD)=36.97(21.40).

Conclusions:

The results indicate the study processes and SDMi is feasible for patients with COPD and PRhp and can be delivered with fidelity. The next step is to assess impact in a fully powered randomised controlled trial.