Article Text
Abstract
Introduction Venous thromboembolism (VTE) is a leading cause of maternal morbidity and mortality during pregnancy. Low-molecular-weight heparin (LMWH) is the suggested agent for thromboprophylaxis of VTE in this population. However, clinical guidelines promote shared decision-making (SDM) due to the preference-sensitive nature of this decision. Given the lack of decision aids in this field, we developed an interactive SDM tool (DASH-TOP).
Methods We conducted two rounds of semi-structured interviews with ten women at risk of VTE in pregnancy. All interviews were recorded and transcribed. We analyzed data with Nvivo, using a deductive content analysis.
Results Details on the findings organized with the honey comb framework domains are provided in figure 1. Overall, DASH-TOP was found to be easy to understand, useful, and desirable. It was also seen as innovative. The second round included a new domain around ‘autonomy of use’, with users reporting that they could navigate the tool independently.
Suggestions provided include the possibility of adding personal experiences, explaining more the medical terms, improving visual presentations, and clarifying exercises’ purpose.
Discussion Women had a positive experience with DASH-TOP, suggesting appropriate design and usability. Participants provided relevant suggestions including adding personal experiences; clarity on the information provided; and, instructions on the iterative components that will be incorporated. DASH-TOP may be used prior to an encounter in order to facilitate a better dialogue with their clinician.
Conclusion Overall, the DASH-TOP tool facilitates informed shared decision-making by providing information often not readily available to patients. Further refinements identified may enhance user experience.