Real-world use and perceptions of shared decision-making for allergy and asthma care in a US population

Jacqueline Eghrari-Sabet; Dennis Williams; Don A Bukstein; Tonya Winders; Donna D Gardner

doi:10.1016/j.waojou.2023.100828

Real-world use and perceptions of shared decision-making for allergy and asthma care in a US population

World Allergy Organ J. 2023 Oct 10;16(10):100828. doi: 10.1016/j.waojou.2023.100828. eCollection 2023 Oct.

Authors

Jacqueline Eghrari-Sabet¹, Dennis Williams², Don A Bukstein³, Tonya Winders⁴, Donna D Gardner⁴

Affiliations

¹ FAAR Institute, Washington DC, USA.
² Division of Pharmacotherapy and Experimental Therapeutics, University of North Carolina, Chapel Hill, NC, USA.
³ Allergy, Asthma & Sinus Center, Milwaukee, WI, USA.
⁴ Allergy & Asthma Network, Fairfax, VA, USA.

Abstract

Background: Shared decision-making (SDM), the process of engaging patients in their healthcare decisions, is an integral component of personalized medicine. The use of SDM in real-world allergy and asthma care in the United States (US) is unknown. Cross-sectional surveys of allergists and patients in a US population were conducted to assess the use and perceptions of SDM and SDM tools in real-world allergy and asthma care.

Methods: Allergists (N = 101) who were members of the American College of Allergy Asthma & Immunology (ACAAI) and who were also Dynata (a marketing research firm) research partners or in the Allergy & Asthma Network customer database completed an online survey from February-March 2022. Adult patients (N = 110) with asthma, allergy, and/or eczema in the United States who were participants of online research panels hosted by Dynata completed on online survey from February 1-7, 2022.

Results: Based on their own definition, 98% of the allergists reported familiarity with SDM, and 79% reported using it frequently. Allergists reported using SDM with an average of 44% of their patients. The most commonly used tool was the Immunotherapy SDM toolkit (40%); 43% had not used any SDM tool. Among allergists not using SDM or using it infrequently (n = 19), 42% considered it too time-consuming and 37% believed their patients have low health literacy. Of the surveyed patients, 25% reported their provider used SDM "frequently" or "occasionally" when being treated for allergies, asthma, or eczema, and 22% reported using SDM tools with their provider at some point. The most commonly used tool was the Asthma and Allergy Symptom Test (60%). Among patients whose allergists used SDM infrequently or never (n = 56), 70% reported they would be likely to ask their allergist to use SDM more often.

Conclusion: Survey responses revealed a disconnect between allergists and patients regarding SDM use. Barriers to SDM are consistent with those across the healthcare industry. Patients clearly expressed their desire for SDM.

Keywords: Allergic; Asthma; Decision making; Eczema; Perception; Rhinitis; Shared.