Scientific Study

Background: Shared decision making (SDM) is the process through which patients and their medical provider mutually explore therapy goals, risks/benefits, and treatment options regarding medical care. Decision-aids are tools to help with the values clarification process and assess decisional needs and potential decisional conflicts. Objective: To develop and assess acceptability of a decision-aid for commercial peanut allergy therapies. Methods: The creation of this decision-aid occurred in three stages, including a qualitative study to assess decisional needs, development of a draft decision-aid through multiple iterations in accordance with international guidelines and decision-aid experts, and assessment of decisional acceptability, decisional conflict, and decisional self-efficacy related to using the decision-aid. Results: The decision-aid went through 9 iterations, resulting in a 4-page aid with 7 parts, explaining the therapies, the key risks and benefits of the therapy choices, the relative importance of key attributes of the therapies, and a self-check assessment regarding informational adequacy and how to take the next steps. Twenty-four subjects assessed the decision-aid, noting it had good acceptability, high decisional self-efficacy (mean score 91.9/100) and low decisional conflict (mean score 20.2/100). Respondents rated the information content as adequate and sufficient, and the information regarding the therapy choices as fair and balanced without a clear bias or presenting a "best choice". Conclusion: We have developed this decision-aid as a tool to help caregivers navigate the complexity of decision-making for peanut allergy treatment options. The decision-aid was noted to have good acceptability, with scores reflective of the instrument enhancing decisional self-efficacy and reducing decisional conflict.