Decisional conflict in asthma patients: a cross sectional study

Abstract

Objective: This study aimed at determining the level of decisional conflict in asthmatic individuals facing recommendation-based decisions provided to improve asthma control. Methods: This was a cross-sectional study performed on a convenience sample of 50 adults aged between 18 and 65 years with a diagnosis of asthma. They completed a decisional conflict scale (possible range of 0–100%), asthma knowledge and control questionnaires (both 0% and 100%), and a general questionnaire on socio-demographic characteristics. A decisional conflict was considered clinically significant with a score greater than 37.5%. Simple descriptive statistics were used to investigate associations with decisional conflict. Results: Participants were mainly women (76%) and diagnosed with mild asthma (72%). The median age (1st and 3rd quartile) was 25 years (22 and 42). The median score (1st and 3rd quartile) of decisional conflict was 33% (24 and 44). A clinically significant score (>37.5%) was obtained in 36% of subjects. A statistically significant negative correlation between the knowledge score and the decisional conflict score (r_p = −0.38; p = 0.006) was observed. The level of knowledge was the only statistically independent variable associated with the decisional conflict score (p = 0.0043). Conclusions: A considerable proportion of patients with asthma have a clinically significant level of decisional conflict when facing decisions aimed at improving asthma control. Patients with poor knowledge of asthma are more at risk of clinically significant level of decisional conflict. These findings support the relevance of providing asthmatic patients with relevant information in decision aids.

• Asthmatic
• decisional conflict scale
• decision-making
• knowledge

Acknowledgement

The authors thank Marie-Eve Boulay, Philippe Prince, and James Hatch for reviewing the manuscript. A special thank to the nurses who referred subjects for this study.

Declaration of interest

Dr. Louis-Philippe Boulet is Chair of the Global Initiative for Asthma Dissemination and Implementation Committee, and holds the Laval University Chair in Knowledge Translation, Prevention and Education in Respiratory and Cardiovascular Health and has no conflict of interest. France Légaré, is Canada Research Chair in Implementation of Shared Decision Making in Primary Care. In addition, Dr Boulet and Dr Légaré are members of Knowledge Translation Canada (KT Canada). Dr Légaré has no conflict of interest. Annick Des Cormiers received funds from Allergen NCE but has no conflict of interest to declare. Finally, Serge Simard has no conflict of interest to declare.