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Development and pilot-testing of patient decision aid for use among Chinese patients with primary open-angle glaucoma
  1. Jennifer W H Shum1,
  2. Wendy W T Lam2,
  3. Bonnie N K Choy1,
  4. Jonathan C H Chan1,
  5. Wing Lau Ho3,
  6. Jimmy S M Lai1
  1. 1Department of Ophthalmology, The University of Hong Kong, Hong Kong, China
  2. 2School of Public Health, The University of Hong Kong, Hong Kong, China
  3. 3Department of Ophthalmology, Queen Mary Hospital, Hong Kong, China
  1. Correspondence to Prof Jimmy S M Lai, Department of Ophthalmology, The University of Hong Kong; laism{at}


Background A patient decision aid (PDA) is a tool for shared decision making (SDM), which emphasises patient empowerment. It is useful in chronic diseases and when there are multiple, no best single treatment option. Although SDM is prevalent in Western countries, its use is limited in Chinese societies, where the adoption of a paternalistic approach is strong. Here, we report the development, acceptance and pilot test results of a PDA targeted at Chinese patients with primary open-angle glaucoma (POAG).

Methods We developed a PDA designed for use in Chinese patients with POAG. Recruited subjects were given our PDA. Baseline evaluation included decision conflict scale (DCS), validated glaucoma adherence questionnaires and glaucoma knowledge questionnaire. Subjects were briefed through the PDA and instructed to read it that day. Three to four weeks later, follow-up questionnaire as described above were conducted with the addition of acceptance questionnaires.

Results Data from 65 subjects were available. The PDA was well received among subjects. DCS improved from 48.9±20.4 at baseline to 34.3±20.3 during follow-up, with P<0.01. Validated medication adherence questionnaires and knowledge showed improvement from baseline, which was statistically significant.

Conclusions The use of PDA among Chinese subjects with POAG demonstrated positive reception and acceptance. Evaluation of its initial effects shows improvement in DCS, medication adherence and glaucoma knowledge. The implementation of SDM and PDA among Chinese subjects with POAG is encouraged. Future studies with randomised design and later evaluation time points can further reveal the impacts of PDA among Chinese subjects with POAG.

  • glaucoma
  • public health

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  • Contributors JS drafted the manuscript and secured funding for this study. WTWL provided expertise on PDA design and testing. BNKC and JC contributed to study design and data analysis. WLH helped with subject recruitment and data interpretation. JSML revised the manuscript critically.

  • Funding The study was funded by the Knowledge Exchange Fund of the University of Hong Kong.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Ethics approval from our Institutional Review Board was obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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