Objective: To assess neurologists’ awareness of, and experience using, patient decision aids.

Background: Patients with Parkinson’s disease (PD), their caregivers, and medical teams encounter numerous treatment decisions throughout the course of the illness. A particularly significant decisional locus exists at the potential transition from a standard pharmacologic treatment regimen to “advanced therapies” that may include device-aided and/or surgical options like DBS. However, there is limited understanding of the decision-making experiences, processes, and needs of these patients, as well as how clinicians can effectively support patients in shared decision-making, including whether a patient decision aid (PtDA) would be beneficial. To address this knowledge gap, we are conducting interviews of various stakeholders involved in these decisions. In this report, we present findings from interviews with medical providers.

Method: Sixteen U.S. based clinicians (seven general neurologists, eight movement disorder specialists, and one registered nurse in a movement practice) were interviewed about their experiences in treating and counseling PD patients who are considering DBS. These semi-structured interviews were recorded, transcribed verbatim, and preliminary qualitative content analysis was performed.

Results: Preliminary analysis suggests that clinicians rely on various sources and formats of information to educate patients about potential advanced therapies for PD. None of the clinicians had experience using a patient decision aid, and many were unfamiliar with the concept altogether. All largely expressed optimism about the potential utility of a PtDA for PD patients considering DBS. There was less consensus about the ideal format, structure, and content of such a PtDA. Additionally, opinions differed on the appropriate timing for using a PtDA in practice with patients and which clinical team members should be involved.

Conclusion: Initial results indicate that healthcare providers recognize the potential benefits of a PtDA to engage PD patients when considering whether to pursue advanced therapy options. However, input from other stakeholders—particularly the patients themselves—is essential to validate these preliminary findings.

(An earlier version of this abstract was selected for presentation at the International Neuroethics Society meeting, April 23-25, 2025.)

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MDS Abstracts - https://www.mdsabstracts.org/abstract/clinicians-views-on-the-use-of-a-patient-decision-aid-for-dbs-in-parkinsons-disease/