Interventions for improving the adoption of shared decision making by healthcare professionals

Légaré, France; Stacey, Dawn; Turcotte, Stéphane; Cossi, Marie-Joëlle; Kryworuchko, Jennifer; Graham, Ian D.; Lyddiatt, Anne; Politi, Mary C.; Thomson, Richard; Elwyn, Glyn; Donner-Banzhoff, Norbert

doi:10.1002/14651858.cd006732.pub3

Cited by 188 publications

(139 citation statements)

References 96 publications

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“…This finding is consistent with prior literature evaluating the effect of decision aids. 1, 2 Indeed, the use of SDM and decision aids (i.e., decision support and information about treatment options) allows patients to become more confident in their choice to have, or not have, surgery 30, 31 which then promotes health and well-being both during and following the decision-making process and operation. 32, 33 …”

Section: Discussionmentioning

confidence: 99%

“…SDM by definition involves a collaborative process that creates a partnership between the doctor and patient. 1, 38 Kennedy et al 39 found that surgery rates were lowest when patients received both a decision aid and an interview, as opposed to a decision aid in isolation. As such, perhaps a distinction between information-based decision-making (i.e.…”

Section: Discussionmentioning

confidence: 99%

“…1 SDM may reduce indiscriminate use of medical interventions and unwanted variation of care by promoting patients’ involvement in their own treatment 1 . Key components of the SDM process include patients’ developing and expressing their personal values as well as treatment goals and preferences, the provider sharing information about clinical context and medical evidence, and a collaborative conversation to make a joint decision that is evidence-based and consistent with best practices.…”

Section: Introductionmentioning

confidence: 99%

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Shared Decision Making and Choice for Elective Surgical Care

Boss¹,

Mehta

Nagarajan³

et al. 2015

Otolaryngol.--head neck surg.

168

151

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Objective Shared Decision-Making (SDM), an integrative patient-provider communication process emphasizing discussion of scientific evidence and patient/family values, may improve quality care delivery, promote evidence-based practice, and reduce overuse of surgical care. Little is known however regarding SDM in elective surgical practice. The purpose of this systematic review is to synthesize findings of studies evaluating use and outcomes of SDM in elective surgery. Data Sources Pubmed, CochraneCENTRAL, EMBASE, CINAHL, and SCOPUS electronic databases Review Methods We searched for English-language studies (1/1/1990 to 8/9/2015) evaluating use of SDM in elective surgical care. Identified studies were independently screened by two reviewers in stages of title/abstract and full-text review. We abstracted data related to population, study design, clinical dilemma, use of SDM, outcomes, treatment choice, and bias. Results Of 10,929 identified articles, 24 met inclusion criteria. The most common area studied was spine (7/24) followed by joint (5/24) and gynecological surgery (4/24). Twenty studies used decision aids/support tools, including modalities that were multimedia/video (13/20), written (3/20), or personal coaching (4/20). Effect of SDM on preference for surgery were mixed across studies, showing a decrease in surgery (9/24), no difference (8/24), or increase (1/24). SDM tended to improve decision quality (3/3) as well as knowledge/preparation (4/6), while decreasing decision conflict (4/6). Conclusion SDM reduces decision conflict and improves decision quality for patients making choices about elective surgery. While net findings show that SDM may influence patients to choose surgery less often, the impact of SDM on surgical utilization cannot be clearly ascertained.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Shared Decision Making and Choice for Elective Surgical Care

Boss¹,

Mehta

Nagarajan³

et al. 2015

Otolaryngol.--head neck surg.

168

151

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“…In both case studies, we learned that a health system that lacks cultural norms such as 'patient-centred approach' or 'shared-decision making' (Légaré et al, 2014) deters providers in engaging in conversations about changing their clients' smoking behaviour.…”

Section: Outer Settingsmentioning

confidence: 99%

Challenges of Integrating Tobacco Cessation Interventions in TB Programmes: Case Studies from Nepal and Pakistan

Dogar

Elsey

Khanal³

et al. 2016

J. Smok Cessat

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I ntroduction: Offering tobacco cessation interventions to TB patients is highly desirable due to the interaction between TB and tobacco use and the potential benefits of quitting. However, implementing such interventions in TB programmes remains a challenge and an under-researched area. Using two initiatives to implement tobacco cessation within TB programmes in Nepal and Pakistan as case studies, we describe these challenges and highlight lessons learnt in the process. Methods: We first conducted a documentary review of all published and unpublished reports of the two initiatives including relevant qualitative and quantitative data and its' analyses. We then analysed this information using the Consolidated Framework for Implementation Research (CFIR) under the five domains of implementation: intervention characteristics, outer settings, inner settings, participant characteristics and the process of implementation. Findings: We faced a number of challenges in implementing tobacco cessation within TB programmes both in Nepal and in Pakistan. These included: doubts about the contextual relevance of the intervention, environments conducive to smoking and political inertia for a cultural shift, service providers' workload, priorities, and their motivation and capacity to deliver tobacco cessation, and inadequate training and support during implementation. We learned that by adapting intervention to the local context, securing mandate from higher authorities, aligning tasks to service providers' roles and receptivity, building capacity through adequate training and providing support, monitoring and feedback during implementation can help in integrating tobacco cessation within TB programmes. Conclusions: Lessons from existing studies can help TB programmes in implementing tobacco cessation interventions and enable greater integration and sustainability of cessation services within routine TB care.

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“…There are numerous types of interventions for facilitating SDM that target the healthcare team, the patient, or the public [8]. However, patient decision aids remain the most widely known effective strategy [9].…”

Section: Introductionmentioning

confidence: 99%

Are mobile health applications useful for supporting shared decision making in diagnostic and treatment decisions?

Rahimi¹,

Menear²,

Robitaille

2017

Global Health Action

Self Cite

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Mobile health (mHealth) applications intended to support shared decision making in diagnostic and treatment decisions are increasingly available. In this paper, we discuss some recent studies on mHealth applications with relevance to shared decision making. We discuss the potential advantages and disadvantages of using mHealth in shared decision making in various contexts, and suggest some directions for future research in this quickly expanding field.

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Interventions for improving the adoption of shared decision making by healthcare professionals

Cited by 188 publications

References 96 publications

Shared Decision Making and Choice for Elective Surgical Care

Shared Decision Making and Choice for Elective Surgical Care

Challenges of Integrating Tobacco Cessation Interventions in TB Programmes: Case Studies from Nepal and Pakistan

Are mobile health applications useful for supporting shared decision making in diagnostic and treatment decisions?

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