Pre-implementation of a decision aid - a multiple case study

Some patients with distal radius fractures may benefit from supervised rehabilitation; however, the evidence is inconclusive and of insufficient quality to guide the decision-making process or to iden-tify which patients are likely to benefit from supervised rather than home-based rehabilitation [Handoll et al, 2015; Mehta et al, 2024]. Both patients and clinicians wish to make decisions regarding postoperative rehabilitation options (wait and see, home-based rehabilitation, supervised rehabilitation) through shared decision-making after distal radius fractures. However, patients often lack access to essential information needed to meaningfully participate in these decisions [Boel et al, 2025]. Decision aids can support shared decision-making by presenting relevant information in a struc-tured and accessible way [Stacey et al, 2025]. Accordingly, the pre-consultation decision aid My Rehabilitation Pathway was developed to facilitate patient-centered decisions regarding post-surgical rehabilitation options following distal radius fractures [Boel et al, in preparation]. Decisions about post-surgical rehabilitation frequently transcend professional boundaries (e.g., surgeons, hand therapists, nurses) and organizational settings (e.g., hospitals and municipalities) [Boel et al, 2025], and they may occur at multiple time points along the rehabilitation trajectory [Collis, 2020; Zhou, 2024]. These characteristics highlight the importance of considering contextual factors for the successful implementation and use of My Rehabilitation Pathway. The aim of this study is therefore to explore the feasibility of pre-implementing the decision aid My Rehabilitation Pathway across different clinical contexts.