{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T09:47:28Z","timestamp":1785577648636,"version":"3.56.0"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T00:00:00Z","timestamp":1744243200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T00:00:00Z","timestamp":1744243200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100006093","name":"Patient-Centered Outcomes Research Institute","doi-asserted-by":"publisher","award":["SDM-2017C2-8224"],"award-info":[{"award-number":["SDM-2017C2-8224"]}],"id":[{"id":"10.13039\/100006093","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["resources"],"award-info":[{"award-number":["resources"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["the use of facilities at the VA Medical Center at Birmingham"],"award-info":[{"award-number":["the use of facilities at the VA Medical Center at Birmingham"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["Alabama"],"award-info":[{"award-number":["Alabama"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["USA"],"award-info":[{"award-number":["USA"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Implement Sci Commun"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Patient decision aids have the potential to lower decision conflict for patients and to improve patient-physician communication. However, uptake of decision aids has been poor, in part because the time required to incorporate these into clinical practice is not well understood.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>To estimate the time required for a rheumatology clinic to implement a validated decision aid for patients with lupus.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Using a cohort of eight implementation sites, study investigators identified the activities required to administer a decision aid. Site coordinators embedded within the clinics timed the duration of each activity. To estimate the effect of viewing the decision aid on the length of the physician\u2013patient interaction, patient visits were timed and the length of visits for patients who viewed the decision aid were compared with visit lengths for three groups of control patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Estimates of the effect of the decision aid on patient visit lengths ranged from a reduction of 3\u00a0min per visit to an increase of 3.88 min per visit, with five out of six estimates suggesting the decision aid is associated with shorter patient visits. Introducing the decision aid to patients took a mean of 4.12 min (median of 2\u00a0min). Identifying patients eligible for the decision aid was a weekly or bi-weekly process for most clinics and took an average of 41.43 min.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>The time required for a rheumatology clinic to implement the decision aid for patients with lupus is low. Our results raise questions about why decision aid take up is low among clinical practices, given the benefits the lupus decision aid offers to patients (reduced decisional conflict and better-informed choice of immunosuppressive medications used for the treatment of lupus kidney disease). More research is needed to identify barriers to decision aid adoption.\n<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s43058-025-00727-8","type":"journal-article","created":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T11:52:31Z","timestamp":1744285951000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Time required to implement a computerized patient decision aid for lupus in outpatient visits"],"prefix":"10.1186","volume":"6","author":[{"given":"Nathan W.","family":"Carroll","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aizhan","family":"Karabukayeva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larry R.","family":"Hearld","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane","family":"Kamen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfred H. 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The IRB allowed a verbal consent before interview of clinic personnel for this study. All patients provided informed consent for the study prior to study participation. All procedures were conducted in accordance with the Ethical principles. The parent study was registered at ClinicalTrials.gov (ID: NCT03735238).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publications"}},{"value":"JAS has received consultant fees from ROMTech, Atheneum, Clearview healthcare partners, American College of Rheumatology, Yale, Hulio, Horizon Pharmaceuticals\/DINORA, Frictionless Solutions, Srchipher, Crealta\/Horizon, Medisys, Fidia, PK Med, Two labs Inc., Adept Field Solutions, Clinical Care options, Putnam associates, Focus forward, Navigant consulting, Spherix, MedIQ, Jupiter Life Science, UBM LLC, Trio Health, Medscape, WebMD, and Practice Point communications; the National Institutes of Health; and the American College of Rheumatology. JAS has received institutional research support from Zimmer Biomet Holdings. JAS received food and beverage payments from Intuitive Surgical Inc.\/Philips Electronics North America. JAS owns stock options in Atai life sciences, Kintara therapeutics, Intelligent Biosolutions, Acumen pharmaceutical, TPT Global Tech, Vaxart pharmaceuticals, Atyu biopharma, Adaptimmune Therapeutics, GeoVax Labs, Pieris Pharmaceuticals, Enzolytics Inc., Seres Therapeutics, Tonix Pharmaceuticals Holding Corp., Aebona Pharmaceuticals, and Charlotte\u2019s Web Holdings, Inc. JAS previously owned stock options in Amarin, Viking and Moderna pharmaceuticals. JAS is on the speaker\u2019s bureau of Simply Speaking. JAS was a member of the executive of Outcomes Measures in Rheumatology (OMERACT), an organization that develops outcome measures in rheumatology and receives arms-length funding from 8 companies. JAS serves on the FDA Arthritis Advisory Committee. JAS is the co-chair of the Veterans Affairs Rheumatology Field Advisory Board (FAB). JAS is the editor and the Director of the University of Alabama at Birmingham (UAB) Cochrane Musculoskeletal Group Satellite Center on Network Meta-analysis. JAS previously served as a member of the following committees: member, the American College of Rheumatology's (ACR) Annual Meeting Planning Committee (AMPC) and Quality of Care Committees, the Chair of the ACR Meet-the-Professor, Workshop and Study Group Subcommittee and the co-chair of the ACR Criteria and Response Criteria subcommittee. AHJK has received consultant fees from Amgen, ANI Pharmaceuticals, Atara Bio, Aurinia Pharmaceuticals, Cargo Therapeutics, Exagen Diagnostics, GlaxoSmithKline, Kypha, Miltenyi Biotech, Synthekine, Technotic Therapeutics. AHJK has received institutional research support from AstraZeneca, Bristol Myers Squibb, GlaxoSmithKline, and Novartis. AHJK has a patent with Kypha. AHJK is a member of OMERACT. AHJK serves on the Rheumatology Research Foundation Board of Directors and chairs their Impact Council and Scientific Advisory Board of the Lupus Research Alliance. ZA receives consulting fees from Amgen, has a clinical trial grant from Aurinia (money paid to my institution: Loyola University). SN receives ongoing support from the Rheumatology Education Group. MM receives support from GSK as a consultant\/speaker, ongoing. Astra Zeneca- consultant\/speaker, ongoing Aurinia- speaker, ongoing, BMS- consultant, ongoing, Genentech- consultant, ongoing, Artivia- consultant, ongoing. CLC is working with Medmastery, an online education company and is PI for a longitudinal study sponsored by Aurinia and co-PI for an ongoing study that has a grant with National Institute of General Medical Sciences of the National Institutes of Health under Award Number U54GM115428. KD serves as a member of the data monitoring committee for a lupus clinical trial and is paid directly an hourly rate (Ongoing) for Alpine Immune Sciences. KD served as the chair of the data monitoring committee for a lupus clinical trial and was paid directly an hourly rate (Ended Jan 2024). KD has served as a consultant on the Global Expert Panel for the IM011 -\u2009246 and IM011 -\u2009247 studies and is paid directly an hourly rate (Ongoing). All other authors declare no relevant conflict of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"41"}}