Do patients with dementia and/or their caregivers who receive a decision support intervention have improved information comprehension, decisional conflict, or engagement in decision making, as compared to patients and/or caregivers who do not receive a decision support intervention?
Searches
Databases:
• Web of Science
• MEDLINE
• EMBASE
• CINAHL
• Cochrane Library
• PsycINFO
• Google Scholar
Concept Terms: Dementia and Decision Support (see protocol for details)
Types of study to be included
No restrictions.
Condition or domain being studied
Dementia.
Participants/ population
Adult patients with a clinical diagnosis of dementia, and their caregivers.
Intervention(s), exposure(s)
Decision support interventions (interventions designed to support individuals in making a well-informed, values-based health care decision). Informational brochures used in clinical care or legal advising that are not focused on a specific health care decision and that were not evaluated in a research study will not be included.
Comparator(s)/ control
None.
Context
No restrictions on setting.
Outcome(s)
Primary outcomes
Information comprehension, Decisional Conflict, or engagement in decision making.
Secondary outcomes
Preparation for decision making, decision self-efficacy, carer self-efficacy, acceptability, usability, feasibility, burden, anxiety, depression, decisional regret, potential for bias.
Data extraction, (selection and coding)
Study Selection
Screening: Three research librarians will search the databases listed above using the pre-specified search terms and compile records into a secure EndNote database, eliminating duplicates. Two independent blinded reviewers will review the title and abstracts of all records obtained by the search strategy to screen for potential eligibility.
Eligibility: Each independent reviewer will then perform a full text review of potentially-eligible studies to confirm eligibility according to the inclusion/exclusion criteria. A third reviewer will resolve discrepancies and lead consensus discussions to resolve uncertainties, resulting in a final database of included studies.
Data Extraction
Two independent blinded reviewers will extract data from each study that met the inclusion criteria using a standardized data collection form. Based on the guidelines of the Cochrane Effective Practice and Organization of Care Group (EPOC), the data collection form assesses the study’s source, methods, participants, interventions, comparison group, and primary and secondary outcomes. This form will be piloted using two studies that meet our inclusion criteria and revised accordingly. It will then be implemented using an online survey to allow for independent, blinded data extraction. If there are multiple publications on the same population or group of patients, the most recent study will be selected for analysis. For missing data, the slots will be filled with “not reported” and the studies will be assessed without that data. For data insufficiencies or questions, the authors of the studies will be contacted for clarification. After both reviewers complete their review, results will be compared for consistency. The third reviewer will resolve any discrepancies.
Risk of bias (quality) assessment
We will critically appraise the quality of the evidence gathered from each study using the GRADE Approach (Grades of Recommendation, Assessment, Development and Evaluation Working Group) to produce a summary of findings table in accordance with the guidelines. (Atkins et al., 2004; Grilli, Magrini, Penna, Mura, & Liberati, 2000)
Strategy for data synthesis
Statistical analyses will assess mean effects on the primary outcomes across studies.
Analysis of subgroups or subsets
Where sufficient records allow, we will assess effects by decision support interventions designed for patients, for caregivers, for both.
Dr Aubri Hoffman, Dartmouth Centers for Health and Aging Dr Daniel Bateman, Dartmouth Centers for Health and Aging Miss Hannah Lee, Dartmouth Centers for Health and Aging
Anticipated or actual start date
03 July 2012
Anticipated completion date
15 December 2012
Funding sources/sponsors
Dartmouth Centers for Health and Aging
Conflicts of interest
None known
Language
English
Country
United States of America
Subject index terms status
Subject indexing assigned by CRD
Subject index terms
Caregivers; Decision Support Techniques; Dementia; Humans; Patient Education as Topic; Patient Participation
Date of registration in PROSPERO
26 July 2012
Date of publication of this revision
26 July 2012
Stage of review at time of this submission
Started
Completed
Preliminary searches
Yes
Piloting of the study selection process
Formal screening of search results against eligibility criteria
Data extraction
Risk of bias (quality) assessment
Data analysis
Prospective meta-analysis
PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites.
