Implementing Shared Decision Making in Interprofessional Home Care Teams (IPSDM-SW)

Implementing Shared Decision Making in Interprofessional Home Care Teams : a Stepped Wedge Cluster Randomized Trial

This study will train health providers in home care teams across Quebec in shared decision making about the decision to stay at home or move to another location. This decision is one of the toughest for older Canadians. Decisions that are informed, shared and supported produce better results. An interprofessional approach to shared decision making is when older persons and their caregivers are supported by not just one but by all the professionals involved in their care.The impact of the training program in interprofessional shared decision making (IPSDM) above that of the passive dissemination of a decision guide will be assessed by measuring to what extent older persons caregivers say they took active part in the decision-making process.

Other outcome measures will be:

i) what option they chose, whether they feel conflict or regret about their decision, and the burden of care they feel; ii) the quality of life of clients;

Study Overview

• Status: Completed
• Conditions: Aging
• Intervention / Treatment: Behavioral: IP-SDM training for health professionals

• Study Type: Interventional
• Enrollment (Actual): 653
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Canada
  • Quebec
    • Québec, Quebec, Canada, G1J 0A4
      • Centre de recherche sur les soins et les services de première ligne de l'Université Laval (CERSSPL-UL)

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

Clients or caregivers of clients :

• Aged ≥65 years;
• Receiving care from the IP home care team of the enrolled CISSS/CIUSSS
• Have made a decision about whether to stay at home or move to another location during the recruitment periods
• Are able to read, understand and write French or English
• Can give informed consent

In the case clients are not able to provide informed consent, their caregiver will be eligible.

Exclusion Criteria:

• Clients who are not able to provide informed consent and who don't have a caregiver

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: None (Open Label)

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Cluster A; IP-SDM training for health professionals (intervention at 4 months)	Behavioral: IP-SDM training for health professionals; Multifaceted SDM training program for providers: i) 1.5-hour online tutorial, ii) 3.5-hour skills building workshop; iii) video-clip demonstrating SDM in the context of an IP home care team with an aging adult making a decision about location of care (to be used with clients and providers as well); and iv) performance feedback to providers (role play during the workshop).
Experimental: Cluster B; IP-SDM training for health professionals (intervention at 11 months)	Behavioral: IP-SDM training for health professionals; Multifaceted SDM training program for providers: i) 1.5-hour online tutorial, ii) 3.5-hour skills building workshop; iii) video-clip demonstrating SDM in the context of an IP home care team with an aging adult making a decision about location of care (to be used with clients and providers as well); and iv) performance feedback to providers (role play during the workshop).
Experimental: Cluster C; IP-SDM training for health professionals (intervention at 18 months)	Behavioral: IP-SDM training for health professionals; Multifaceted SDM training program for providers: i) 1.5-hour online tutorial, ii) 3.5-hour skills building workshop; iii) video-clip demonstrating SDM in the context of an IP home care team with an aging adult making a decision about location of care (to be used with clients and providers as well); and iv) performance feedback to providers (role play during the workshop).
Experimental: Cluster D; IP-SDM training for health professionals (intervention at 25 months)	Behavioral: IP-SDM training for health professionals; Multifaceted SDM training program for providers: i) 1.5-hour online tutorial, ii) 3.5-hour skills building workshop; iii) video-clip demonstrating SDM in the context of an IP home care team with an aging adult making a decision about location of care (to be used with clients and providers as well); and iv) performance feedback to providers (role play during the workshop).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Assumed Role in decision making	To assess the proportion of caregivers reporting an active role, a modified version of the Control Preferences Scale designed to assess the role assumed in the decision making process will be used. The scale consists of a single question and is the one most frequently used in studies assessing the implementation of SDM in clinical practice.	7 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Patient involvement in decision making	Assessed with the Dyadic-OPTION scale, a 12-item self-administered instrument that assesses 12 specific SDM behaviours during the decision-making process	7 months
Decisional Regret	Assessed with the Decisional Regret Scale	7 months
Decisional Conflict	Assessed with the Decisional Conflict Scale	7 months
Health-related quality of life	Assessed with two subscales (Social isolation and Emotional reactions) of the HR-QoL questionnaire from the Nottingham Health Profile, clients only	7 months
Burden of care	Assessed with the Zarit Burden Inventory Scale (ZBI), caregivers only	7 months
Preferred and chosen option (remain at home or move to another location)	Questionnaire assessing the prefered and chosen option	7 months

Collaborators and Investigators

• Sponsor: CHU de Quebec-Universite Laval
• Collaborators: Canadian Institutes of Health Research (CIHR)
• Investigators: Principal Investigator: France Légaré, Ph. D., Laval University

Publications and helpful links

General Publications

• Adisso EL, Taljaard M, Stacey D, Briere N, Zomahoun HTV, Durand PJ, Rivest LP, Legare F. Shared Decision-Making Training for Home Care Teams to Engage Frail Older Adults and Caregivers in Housing Decisions: Stepped-Wedge Cluster Randomized Trial. JMIR Aging. 2022 Sep 20;5(3):e39386. doi: 10.2196/39386.
• Legare F, Briere N, Stacey D, Lacroix G, Desroches S, Dumont S, Fraser KD, Rivest LP, Durand PJ, Turcotte S, Taljaard M, Bourassa H, Roy L, Painchaud Guerard G. Implementing shared decision-making in interprofessional home care teams (the IPSDM-SW study): protocol for a stepped wedge cluster randomised trial. BMJ Open. 2016 Nov 24;6(11):e014023. doi: 10.1136/bmjopen-2016-014023.

Helpful Links

• Related Info

Study record dates

Study Major Dates

• Study Start (Actual): November 1, 2015
• Primary Completion (Actual): December 1, 2018
• Study Completion (Actual): December 1, 2018

Study Registration Dates

• First Submitted: October 28, 2015
• First Submitted That Met QC Criteria: October 29, 2015
• First Posted (Estimate): October 30, 2015

Study Record Updates

• Last Update Posted (Actual): December 20, 2019
• Last Update Submitted That Met QC Criteria: December 18, 2019
• Last Verified: December 1, 2019

More Information

Terms related to this study

• Other Study ID Numbers: 2015-2016 01-01-E