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Patient decision aids (PDAs)

Learn about patient decision aids: what they are and how to use them.

What are patient decision aids (PDAs)?

PDAs are tools that help patients and providers talk together about care options. PDAs help patients understand their choices about whether to have a specific treatment or screening. This includes knowing the pros and cons of each available option.  

PDAs also provide patients with information needed to make a decision, based on their personal values and preferences, by exploring each option and how it relates to their values. For example, a PDA could help a pregnant woman decide whether to attempt a natural birth after having a cesarean.

Research shows that PDAs lead to increased knowledge and a more accurate understanding of risk. When using a PDA, more patients feel comfortable with the decisions they make and the care they receive.

How does the Health Care Authority (HCA) ensure the quality of PDAs?

Washington State law supports and regulates shared decision making and the certification of PDAs. In addition, Washington is the only state in the nation to certify PDAs. HCA began accepting PDAs for certification in April 2016.

What PDAs has HCA certified?

According to Washington Administrative Code (WAC) 182-60-040, a certification is valid for two years from the date of the written certification determination, except for withdrawal or suspension. The following PDAs marked with an asterisk* are currently undergoing the process for review for recertification. If a PDA does not have an asterisk, its certification is still valid.

PDA Organization Audience Description
Prenatal genetic testing: Understanding your options Emmi Solutions Women before conception or early in the first trimester.

Educates patients about prenatal genetic testing options.

PDA certification date: February 19, 2021

PDA Organization Audience Description
Treatment options for knee osteoarthritis Emmi Solutions LLC
300 W Adams
Suite 1200
Chicago, IL 60606
People with hip osteoarthritis. It is appropriate for patients throughout the disease continuum, from people who are newly diagnosed and/or have mild symptoms to those who have had it long-term and/or have severe symptoms.

This PDA is made available to all Emmi clients (primarily hospitals and health care systems) with a subscription to EmmiEngage or EmmiDecide product lines.

Clinicians/health care teams administer the PDA to patients in preparation for a decision around knee OA treatment options.

PDA certification date: June 3, 2021

Treatment options for hip osteoarthritis Emmi Solutions LLC
300 W Adams
Suite 1200
Chicago, IL 60606
People with hip osteoarthritis. It is appropriate for patients throughout the disease continuum, from people who are newly diagnosed and/or have mild symptoms to those who have had it long-term and/or have severe symptoms.

This PDA is made available to all Emmi clients (primarily hospitals and health care systems) with a subscription to EmmiEngage or EmmiDecide product lines.

Clinicians/health care teams administer the PDA to patients in preparation for a decision around knee OA treatment options.

PDA certification date: October 1, 2020

Herniated disk in lower back: treatment options EBSCO Publishing, Inc.
10 Estes St, Ipswich, MA 01938
People with back pain due to a herniated disk for greater than six weeks. It is not for people with back pain from other causes, a herniated disk without symptoms, or symptoms for less than six weeks.

This decision aid is designed to help people with a herniated (slipped) disk understand surgical and nonsurgical treatment options for reducing pain and improving function.

PDA certification date: July 12, 2019

Stenosis of lower back: treatment options for spinal narrowing option grid EBSCO Publishing, Inc.
10 Estes St, Ipswich, MA 01938
People with nerve problems, or back or leg pain from other causes.

This decision aid is for people with nerve problems, or back or leg pain from other causes. Stenosis of the lower back, or lumbar spinal stenosis, is a narrowing of the space where nerves are in your back. It can cause back and leg pain, and it might limit what you can do.

PDA certification date: October 7, 2019

Hip osteoarthritis: treatment options EBSCO Publishing, Inc. 10 Estes St, Ipswich, MA 01938 People with pain, stiffness, and reduced ability to move due to osteoarthritis of the hip. It is not for people who do not have symptoms, who have other causes of arthritis, or who have already had hip surgery.

This decision aid compares two treatment options, including treatment without surgery and hip replacement, to help people with pain, stiffness, and reduced ability to move due to osteoarthritis of the hip understand their available options and to make the best choice for themselves.

PDA certification date: January 31, 2020

Knee osteoarthritis: treatment options EBSCO Publishing, Inc. 10 Estes St, Ipswich, MA 01938 People with pain, stiffness, and reduced ability to move due to osteoarthritis of the knee. It is not for people who have other causes of arthritis or who have already had knee surgery.

This decision aid compares 12 different treatment options to help people with pain, stiffness, and reduced ability to move due to osteoarthritis of the knee understand their available options and to make the best choice for themselves.

PDA certification date: January 31, 2020

ACP Decisions

The following PDAs are from ACP Decisions. For more information about any of the following tools, please contact executivedirector@acpdecisions.org or acpdecisions.org/contact.

PDA Audience Description

CPR: advanced cancer

Any competent adult (and their surrogate decision-makers in the event of incapacity) with advanced cancer who is making a decision about whether or not they wish to have CPR attempted

Explores whether or not a patient with advanced cancer would like CPR attempted in the hospital.

PDA certification date: May 19, 2021

CPR: advanced disease

Any competent adult (and their surrogate decision-makers in the event of incapacity) with advanced disease who is making a decision about whether or not they wish to have CPR attempted

Explores whether or not a patient with advanced disease would like CPR attempted in the hospital.

PDA certification date: May 19, 2021

CPR: advanced heart failure

Any competent adult (and their surrogate decision-makers in the event of incapacity) with advanced heart failure who is making a decision about whether or not they wish to have CPR attempted

Explores whether or not a patient with advanced heart failure would like CPR attempted in the hospital. 

PDA certification date: May 19, 2021

CPR: advanced liver disease

Any competent adult (and their surrogate decision-makers in the event of incapacity) with advanced liver disease who is making a decision about whether or not they wish to have CPR attempted

Explores whether or not a patient with advanced liver disease would like CPR attempted in the hospital.

PDA certification date: May 19, 2021

CPR: advanced lung disease

Any competent adult (and their surrogate decision-makers in the event of incapacity) with advanced lung disease who is making a decision about whether or not they wish to have CPR attempted

Explores whether or not a patient with advanced lung disease would like CPR attempted in the hospital.

PDA certification date: May 19, 2021

CPR: a closer look for people with a serious illness

Any competent adult (and their surrogate decision-makers in the event of incapacity) with a serious illness who is making a decision about whether or not they wish to have CPR attempted

Explores whether or not a patient with a serious illness would like CPR attempted in the hospital.

PDA certification date: May 19, 2021

Decisions about dialysis for patients 75 and older*

Any competent adult over the age of 75 with frailty (and their surrogate decision-makers in the event of incapacity) who is making a decision about whether or not they wish to have dialysis attempted or pursue supportive kidney care for end-stage renal failure and chronic advanced kidney disease

Explores treatment options for patients with end-stage renal disease or advanced chronic kidney disease.

Goals of care: advanced cancer*

Any competent adult (and their surrogate decision-makers) with advanced cancer who is making a decision about what type of medical care they would want if they became ill

Explores what level of medical care a patient with advanced cancer desires in a health care setting.

Goals of care: advanced dementia*

Any competent adult (and their surrogate decision-makers) who is considering medical care if they had advanced dementia and is making a decision about what type of medical care they would want if they became ill.

Explores what level of medical care a patient with advanced dementia desires in a health care setting.

Goals of care: advanced disease*

Any competent adult (and their surrogate decision-makers) with advanced disease who is making a decision about what type of medical care they would want if they became ill

Explores what level of medical care a patient with advanced disease desires in a health care setting.

Goals of care: advanced heart failure*

Any competent adult (and their surrogate decision-makers) with advanced heart failure who is making a decision about what type of medical care they would want if they became ill

Explores what level of medical care a patient with advanced heart failure desires in a health care setting.

Goals of care: advanced lung disease*

Any competent adult (and their surrogate decision-makers) with advanced lung disease who is making a decision about what type of medical care they would want if they became ill

Explores what level of medical care a patient with advanced lung disease desires in a health care setting.

Goals of care: family meetings in the ICU*

Any surrogate who is making a decision for a patient in the intensive care unit setting about what type of medical care they would want for their loved one

Explores what level of medical care a surrogate (health care proxy, family or friends) desires for their loved one in an intensive care unit setting.

Goals of care: skilled nursing facility*

Any competent adult (and their surrogate decision-makers) who is making a decision about what type of medical care they would want if they became ill in the skilled nursing facility setting

Explores what level of medical care a patient desires in a health care setting, specifically the skilled nursing facility.

Hospice: advanced cancer*

Any competent adult (and their surrogate decision-makers in the event of incapacity) with advanced cancer who is making a decision about whether or not they wish to have hospice

Explores whether or not a patient with advanced cancer wishes to receive hospice care; reviews what hospice is, the benefits and limits of hospice, and the goal of hospice.

Hospice: skilled nursing facility*

Any competent adult (and their surrogate decision-makers in the event of incapacity) who is making a decision about whether or not they wish to have hospice in the skilled nursing setting

Explores whether or not a patient in a skilled nursing facility wishes to receive hospice care; reviews what hospice is, the benefits and limits of hospice, and the goal of hospice.

Hospice: an introduction*

Any competent adult (and their surrogate decision-makers in the event of incapacity) who is making a decision about whether or not they wish to have hospice

Explores whether or not a patient wishes to receive hospice care; reviews what hospice is, the benefits and limits of hospice, and the goal of hospice.

Supporting decisions involving extremely premature infants*

Any parent who is making decisions about an extremely premature infant

Explores decisions surrounding medical care for infants born extremely premature; reviews the two general approaches that neonatal intensive care units (NICUs) use for medical care for extremely premature infants, namely, life-prolonging care and comfort care.

Dementia for caregivers: goals of care: across the spectrum for Alzheimer's disease* Any competent adult (and their surrogate decision-makers in the event of incapacity) who is considering medical care if they had one of the stages of dementia and is making a decision about what type of medical care they would want if they became ill Explores what level of medical care a patient with one of the stages of dementia desires if they become ill and how surrogate decision makers can aid in the decision making process.

Respecting Choices

The following PDAs are from Respecting Choices. For more information, email info@respectingchoices.org or call 608-473-1025.

Learn more by visiting Respecting Choices' website.

PDA Audience Description

CPR decision aid

People with serious illness (like heart or lung disease or cancer) facing a decision about attempting CPR

Individuals are guided to consider what care they would want if their heart and breathing stops. This decision aid will help an individual consider his/her options for CPR and personal values.

PDA certification date: January 4, 2021

Help with breathing decision aid

People with underlying, serious illness (like heart or lung disease or cancer) facing a decision about getting short-term help with breathing

Individuals are guided to consider what care they would like if they were not able to breathe on their own. This may occur if a person has a problem, like pneumonia, from his/her serious illness. This pneumonia perhaps can be treated, but the person would need help with breathing. This decision aid will help an individual consider his/her options and personal values.

PDA certification date: January 4, 2021

Long-term tube feeding decision aid

People with serious illness (like heart or lung disease, dementia, or cancer) facing a decision about the use of long-term tube feeding

Individuals are guided to consider what care they would want if their illness or disability made it hard to swallow and they were no longer able to eat or drink enough by mouth to maintain nutrition. This decision aid will help an individual consider his/her options and personal values and beliefs.

PDA certification date: January 4, 2021

PDA Organization Topic Audience Description

Option grid: implantable cardioverter defibrillator for heart failure: yes or no?

EBSCO Publishing, Inc. 10 Estes St, Ipswich, MA 01938

To decide whether or not to get an implantable cardioverter defibrillator (ICD) for patients with heart failure.

Patients with heart failure from blocked arteries or a heart attack and who might benefit from an ICD.

This decision aid is for people with heart failure facing a decision about whether or not to get an ICD. This decision aid compares two options: "yes to ICD" and "no to ICD".

Ischemic heart disease: treatment options for chest pain from one blocked artery

EBSCO Publishing, Inc. 10 Estes St, Ipswich, MA 01938

To decide between treating chest pain from one blocked artery by continuing to only take medicines or by unblocking the artery using a stent.

Patients with chest pain from one blocked artery. It is not for patients who have no pain, pain that happens while at rest, or pain that is getting worse. It is not for patients with more than one blocked artery or high-risk blockages.

This decision aid is for patients with chest pain from one blocked artery to decide between treating chest pain from one blocked artery by continuing to only take medicines or by unblocking the artery using a stent.

Atrial fibrillation: treatment options to lower stroke risk EBSCO Publishing, Inc. 10 Estes St, Ipswich, MA 01938 To help patients with atrial fibrillation decide between treatment options to lower their risk of stroke. Patients with atrial fibrillation, except those with atrial fibrillation due to heart valve problems. This decision aid compares eight different treatment options to help patients with atrial fibrillation lower their risk of stroke. This is not for those patients with atrial fibrillation due to heart valve problems.
Caregiver academy: decisions about breathing and feeding tubes ACP Decisions (nonprofit foundation) 195 Carlton Road, Waban, MA 02468 Cardiopulmonary resuscitation (CPR) and whether or not to attempt in patients with advanced cancer Any caregiver who is making a decision for an intubated patient in the intensive care unit setting regarding tracheostomy and a feeding tube. This decision aid explores decisions surrounding tracheostomies and feeding tubes for patients who are on a ventilator and intubated. These decisions are often made by a caregiver (health care proxy, surrogate, family, or friends) in an intensive care unit setting for a patient who is presently intubated and on a ventilator.
Intubation and breathing machines: a closer look for people 65 and over ACP Decisions (nonprofit foundation), 195 Carlton Road, Waban, MA 02468 Intubation and breathing machines for people 65 and over Any competent adult over the age of 65 (and their surrogate decision-makers in the event of incapacity) who is making a decision about whether or not they wish to have intubation and mechanical ventilation attempted. The decision aid explores the issue of whether or not a patient over 65 would like to be intubated if they are unable to breathe on their own.

PDA

Organization

Audience

Description

Should I Get a Mammogram? (ages 40-49)

Confluence Health
1201 S. Miller St.
Wenatchee, WA 98801

All women, ages 40-49

This PDA is to help women, ages 40-49, decide if they want to start having mammograms before age 50 and how often to get them, if a woman decides to start having mammograms.

PDA certification date: March 1, 2021

How Often Should I Get a Mammogram? (ages 50-74)

Confluence Health
1201 S. Miller St.
Wenatchee, WA 98801
All women, ages 50-74

This PDA is to help women, ages 50-74, decide how often to get screening mammograms.

PDA certification date: March 1, 2021

Should I Get a Mammogram? (ages 75+)

Confluence Health
1201 S. Miller St.
Wenatchee, WA 98801
All women, ages 75 and older

This PDA is to help women, ages 75 and older, decide if they want to stop or continue getting mammograms.

PDA certification date: March 1, 2021

Is HCA currently accepting certified PDAs?

Health Care Authority (HCA) is currently accepting patient decision aids for the topic of behavioral health (mental health and substance use disorder). There is an application fee of $3,000 for review of each decision aid. Fees will be waived for aids made available to the public at no charge.

If you would like to submit an application and patient decision aid for consideration for certification, please fill out the following application materials and submit electronically to shareddecisionmaking@hca.wa.gov.

Please submit payment for the application fee, along with the following Fee Submission Form to the address listed.

Please send any questions about the application process to shareddecisionmaking@hca.wa.gov.

What happens after HCA certifies a PDA?

  1. HCA notifies the developer of our decision to certify the PDA.
  2. We post information about the PDA and developer. This includes a link to the developer's website, and if available, the certified PDA.

Can I use the PDAs on this page?

Not all PDAs are free or available to the public. In some cases:

  • There may not be a link to the certified PDA.
  • A PDA may only be available through a provider or health care system.
  • Providers may be required to pay a fee to use a PDA with their patients.

Although called "patient" decision aids, PDAs are tools providers can use as part of shared decision making with their patients.

Contact

Email: shareddecisionmaking@hca.wa.gov
Name: Laura Pennington​, quality measurement and improvement manager
Phone: 360-725-1231