Implementing patient decision support tools: Moving beyond academia?

OBJECTIVE: To ascertain the feasibility of implementing three decision support tools (DSTs) for people with rectal cancer within the surgical consultation. METHODS: Twenty colorectal surgeons participated in a focus group or individual interviews. Colorectal surgeons were also asked to complete a self-administered questionnaire. RESULTS: All surgeons responded encouragingly to the concept of DSTs. However, for every positive statement an accompanying caveat was made and these were either a criticism of each tool or a barrier to their implementation. Surgeons stated DSTs should be used by patients and surgeons together (80%). The majority (70-75%) thought each tool was 'useful' or 'extremely useful'. However, there were strong views that in their current form the DSTs would not feasible to be used within the surgical consultation. Time restraints, personal and clinical characteristics of the patient, the content of each tool, the potential negative impact on the doctor-patient relationship were noted as real barriers to their implementation. CONCLUSION: Surgeons have identified a number of barriers that may limit implementation of DSTs into routine clinical practice. PRACTICE IMPLICATIONS: Feasibility and implementation studies have the potential to provide important information to help guide development, evaluation and implementation of DSTs.