General practitioners' perceptions on decision aids in healthcare: a qualitative study in Portugal.

Background: Decision aids (DA) are evidence-based tools that support health-related decisions. Despite their recognised value, the use of DAs in primary care remains modest. In Portugal, clinical guidelines focus on clinical decision-making with minimal patient engagement. Adapting international DAs to the Portuguese context could be an efficient way to support the transition to shared decision-making. Understanding general practitioners' (GPs) awareness and perceptions of DAs is essential before evaluating their willingness to adopt these tools for specific clinical problems.

Aim: To explore Portuguese GPs' perceptions of DAs and their implementation in primary care.

Method: Qualitative study with GPs and GP trainees in Portugal. Seven online focus groups were conducted with 33 GPs and GP trainees selected through purposive sampling. Data were analysed using deductive content analysis.

Results: Most participants initially confused DAs with clinical decision support tools; only one recognised them as aids for shared decision-making. After clarification, GPs expressed favourable attitudes and believed that patients were willing to use DAs. Key barriers to adoption included limited funding, time constraints, and the lack of Portuguese translations. Facilitators involved system integration and localisation. Priority topics centred on prevention (screening, statin use, vaccines, contraception, lifestyle changes) and specific medications (antibiotics, hormone replacement, psychotropics).

Conclusion: Although unfamiliar to most participants, integrating DAs in primary care was well received, and these tools may provide added value in improving the quality of health decisions.

Clinical trial number: Not applicable.