DECISION+2: Randomized Control Trial
Acute respiratory tract infections (ARIs) such as otitis media, rhinosinusitis, acute pharyngitis and bronchitis account for up to 10% of consultations in emergency departments. Several studies have shown that these infections are overwhelmingly of viral etiology and therefore self-limiting. Although antibiotic therapy is unnecessary in the treatment of acute respiratory infections of viral etiology, the use of antibiotics is still widespread among clinicians in North America. Inappropriate antibiotics consumption is associated with antibiotic resistance, increased risk of side effects and a higher rate of readmission. This is a major public health problem. Information tools are a promising way to inform patients and doctors about this problem. Information tools can support informed decision-making about an individual health issue. This can open the dialogue for shared decision-making between the patient and the doctor. Shared decision-making is a decision-making process in which the physician, the patient, and those around them share information that is informed by the highest level of evidence, evaluate all possible diagnostic and therapeutic options, identify the patient's priorities, deliberate, and jointly decide on the best care for the patient. This project was based on the data gathered during a pilot randomized control trial of Decision+. The main aim of the pilot was to establish the feasibility of conducting the project on a larger scale. The pilot project assessed the impact of DECISION+ on antibiotics use for acute respiratory infections (ARI) – the main reason for consultations in primary care. This project was funded by the FRSQ-Conseil du Medicament.
Project Financing Agency
This project is funded by the FRSQ-Conseil du médicament.
Start and end dates for project financing
2009 to 2012
- Couët N, Labrecque M, Robitaille H, Turcotte S, Légaré F. The impact of DECISION+2 on patient intention to engage in shared decision making: Secondary analysis of a multicenter clustered randomized trial. Submitted to Health Expectations.
- Turcotte S, Guerrier M, Labrecque M, Robitaille H, Rivest LP, Hess B, Légaré F. Dyadic validity of the Decisional Conflict Scale for patients and their physicians. Submitted to the Journal of Clinical Epidemiology.
- Ferron Parayre A, Labrecque M, Rousseau M, Turcotte S, Legare F. Validation of SURE, a four-item clinical checklist for detecting decisional conflict in patients. Medical decision making: an international journal of the Society for Medical Decision Making. 2014 Jan;34(1):54-62.
- Giguere A, Labrecque M, Njoya M, Thivierge R, Legare F. Development of PRIDe: A tool to assess physicians' preference of role in clinical decision making. Patient Education and Counseling. 2012 Aug;88(2):277-83
- Légaré F, Labrecque M, Cauchon M, Castel J, Turcotte S, Grimshaw J.Training family physicians in shared decision-making to reduce the overuse of antibiotics in acute respiratory infections: a cluster randomized trial.2012/05/01. Eng. CMAJ. 2012 Sep 18;184(13):E726-34.
- Allaire AS, Labrecque M, Giguere A, Gagnon MP, Legare F. What motivates family physicians to participate in training programs in shared decision making? The Journal of Continuing Education in the Health Professions. 2012 Mar;32(2):98-107.
- Légaré F, Guerrier M, Nadeau C, Rhéaume C, Turcotte S, Labrecque M. Impact of DECISION + 2 on patient and physician assessment of shared decision making implementation in the context of antibiotics use for acute respiratory infections. Implement Sci. 2013 Dec 26;8:144.
- Leblanc A, Legare F, Labrecque M, Godin G, Thivierge R, Laurier C, et al. Feasibility of a randomised trial of a continuing medical education program in shared decision-making on the use of antibiotics for acute respiratory infections in primary care: the DECISION+ pilot trial. Implementation Science : IS. 2011;6:5.
- Guerrier M, Légaré F, Turcotte S, Labrecque M, Rivest LP. Shared decision making does not influence physicians against clinical practice guidelines. PLoS One 2012; 8(4):e62537.
- Légaré F, Labrecque M, Godin G, Leblanc A, Laurier C, Grimshaw J, Castel J, Tremblay I, Frémont P, Cauchon M, Lemieux K, Rhéaume C. Training family physicians and residents in family medicine in shared decision making to improve clinical decisions regarding the use of antibiotics for acute respiratory infections: protocol for a clustered randomized controlled trial. BMC Fam Pract. 2011 Jan 26;12(1):3