Journal of Telemedicine and Telecare > Volume 16, Number 1 > Pp. 48-52

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PAPERS

Feasibility of web-based decision aids in neurological patients

Janine A van Til ^* , Constance H C Drossaert ^*, Gerbert J Renzenbrink , Govert J Snoek , Evelien Dijkstra ^*, Anne M Stiggelbout  and Maarten J IJzerman ^*

^* Health Technology and Services Research, University of Twente, Enschede; Centre for Rehabilitation "Het Roessingh", Enschede; Leids Universitair Medical Center, Leiden, The Netherlands

Correspondence: Dr J A van Til, Health Technology and Services Research, University of Twente, PO Box 217, 7500 AE Enschede, The Netherlands (Fax: +31 53 480 2159; Email: j.a.vantil{at}utwente.nl)

Decision aids (DAs) may be helpful in improving patients' participation in medical decision-making. We investigated the potential for web-based DAs in a rehabilitation population. Two self-administered DAs focused on the treatment of acquired ankle-foot impairment in stroke and the treatment of arm-hand function in cervical spinal cord injury (SCI). Data collection comprised a telephone interview and a self-reported paper questionnaire. Of the patients who agreed to participate, 39 stroke patients (44%) and 38 patients with SCI (78%) returned a questionnaire. More than 75% of patients expressed a need for more information about the treatment of disease-related impairment. The DAs were highly appreciated by both patient groups. Nearly all patients expressed a positive attitude towards the use of the web-based DAs in general practice. The DAs had a positive effect on the knowledge about the treatment alternatives in the stroke patients (P = 0.001), although not in the patients with SCI. The DAs reduced patients' conflict about treatment (P < 0.05). The effect of the DAs on patients' desired role in decision-making was limited. Web-based aids are feasible in the rehabilitation population with access to a computer and can improve the knowledge gaps in patients.

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