Fifteen health care providers and fifteen patients took part in the interviews. From their responses, five key themes were identified:

1. Decision making: Many health care providers tend to make decisions for rheumatoid arthritis patients without involving them much.
2. Patient needs: Patients want emotional support and educational tools to help them take part in making decisions about their treatment.
3. Implementation feasibility: There are many practical challenges to using decision aids in current arthritis-related healthcare systems.
4. Flexibility: Being flexible in how decision aids are implemented is important for success.
5. Health care provider training: Many health care providers are not very interested in getting more training on using decision aids.

Once the themes were mapped onto the COM-B framework, six recommendations were identified by the researchers and patient partners to increase the use of decision aids:

1. Make decision aids easily accessible to patients and provide education on shared decision-making via websites, social media, etc.
2. Develop an education curriculum for rheumatologists on shared decision making.
3. Use decision coaches or patient partners to support patients.
4. Connect decision aids with up-to-date rheumatoid arthritis guidelines.
5. Include shared decision making through the use of decision aids as a normalized standard of care.
6. Conduct trials to see how using decision aids and shared decision-making affects patients.

This research revealed the challenges and helped to identify proposed steps for implementing decision aid use in rheumatoid arthritis care in Canada.