Development of a paediatric asthma shared decision-making tool: intervention design and evaluation

Asthma is the most common chronic disease in children, yet adherence to treatment remains poor due to barriers in communication and self-management. Shared decision-making (SDM) can improve adherence, but no decision aid currently exists for paediatric asthma. This gap limits children’s engagement in treatment decisions, highlighting the need for a tailored patient decision aid. The aim was to develop a decision aid to support SDM between children with asthma, their parents, and healthcare providers (HCPs), followed by an evaluation of its acceptability and usability. A user-centred, iterative co-design approach was used, involving children aged 6–18 years with physician-diagnosed asthma, their parents, and healthcare providers (including paediatricians, asthma nurses, and general practitioners). An initial needs assessment identified key challenges in asthma-related decision-making. These insights informed eight structured co-creation sessions focusing on identifying decision points, exploring preferences, and shaping content and format of the decision aid. Usability and acceptability were tested with end-users, and the final version was independently reviewed against the IPDAS checklist by two researchers to assess quality and completeness. A needs assessment (n = 37) with HCPs, patients, and caregivers identified substantial information gaps, with many patients and parents unaware of treatment options or potential side effects. HCPs emphasised the potential value of a decision aid in improving information delivery and encouraging SDM. In eight co-creation sessions, a multidisciplinary group (n = 18) collaborated to develop and refine two complementary decision aids. Feedback highlighted improved clarity, age-appropriate design, and relevance for real-life consultations. In the final phases, both decision aids were tested for acceptability and usability, showing high user satisfaction with minor revisions made (n = 32). A quality assessment was conducted by two independent reviewers. Both tools met all 12 IPDAS criteria. These results confirm their quality and suitability for implementation in practice. The decision aids were well received by patients, parents and HCPs and met IPDAS criteria. They address critical unmet needs in paediatric asthma care by supporting informed decision-making. These tools have the potential to improve the quality of clinical consultations and promote more patient-centred care in the treatment of childhood asthma. Not applicable.