Participatory Co-design of a novel website to improve GPs' understanding of the benefits and harms of treatments for long-term conditions.
Problem
GPs regularly prescribe lifelong treatments for long-term conditions, supported by clinical guidelines and encouraged by performance measures. However, GPs have a poor understanding of the absolute benefits and harms of these treatments, impairing their ability to engage in genuine shared decision making or optimally manage polypharmacy. There are few easily accessible and understandable sources of this kind of quantitative information.
The aim of the project was to produce a novel website to communicate understandable, usable information to GPs on the benefits and harms of treatments for long-term conditions, in a way which will be usable and useful in everyday clinical practice.
Approach
A mixed-methods approach employing participatory co-design and research-through-design principles:
Patient and Public Involvement including an Expert and Patient Steering Committee.
Qualitative Interview study with GPs.
A joint application design workshop, multiple cycles of iterative user-testing, focus groups and pair-writing.
User-centred Content Design methods.
A pragmatic evidence search, review, collation and curation process, drawing principally on NICE and Cochrane evidence reviews.
Preliminary evaluation study using online GP focus groups including clinical vignette-based questionnaires and open discussion.
Findings
A new website, gpevidence.org (launched 01/02/22) was developed providing evidence on treatments for 12 common long-term conditions. The website itself represents the main research finding, in keeping with the principle of research-through-design whereby new artifacts (products, environments, services, and systems) are themselves a type of implicit, theoretical contribution.
It employs graphic design and "content-designed" textual information within an information architecture mapping to GPs' practice and mental models.
User-testing and preliminary evaluation have shown it successfully communicates complex evidence about the benefits and harms of treatments to GPs in a way that is understood and which will be usable and useful in practice.
Consequences
It is possible to communicate quantitative information about the clinical evidence base behind treatments in a way that will be usable in practice and that complements existing clinical guidelines and normative practice. This has potential to support shared decision making, improve the management of polypharmacy and multimorbidity, and increase GPs' confidence in this area of practice.