arriba – A Decision Aid for General Practice

Johannes Hauswaldt, Attila Altiner, Norbert Donner-Banzhoff

Keywords: decision aid; shared decision making; general practice

Background:

Shared decision-making (SDM) has been a buzzword for all those working on improving health care systems. While this kind of arriving at decisions about screening, diagnosis and treatment is not disputed, implementation in practice has been incomplete. Decisions aids (DAs) are meant to help patients and doctors to improve knowledge, clarify values and agree on a common management strategy. Arriba is a DA to be used during the consultation by patients and GPs together.

Research questions:

What are the wants and needs of GPs regarding SDM in their practice? What are the expectations of patients? Which kinds of DAs are available? Which of them have been successful?

Method:

Currently available arriba software modules will be presented, the underlying evidence base and effectiveness studies conducted so far.

Results:

Arriba has been the most popular DA used in German General Practice. Originally developed for cardiovascular prevention, software modules now cover a range of clinical topics such as depression, oral anticoagulation for atrial fibrillation, screening for prostate cancer and aortic aneurysm and several more. Some of them have been implemented by contracts with health insurance organizations.

Conclusions:

The active support by a community of GPs active in teaching and research has been a crucial factor for the success of arriba.

Points for discussion:

Are DAs available in participants’ countries? Are they adapted to the general practice setting?

Have they been disseminated successfully? What are enabling factors or barriers?

What are the consequences for future developments?

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