Physician attitudes toward shared decision making: A systematic review

Pollard, Samantha; Bansback, Nick; Bryan, Stirling

doi:10.1016/j.pec.2015.05.004

Cited by 190 publications

(189 citation statements)

References 63 publications

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“…In another systematic review (Pollard, Bansback, and Bryan 2015), the authors list healthcare professional-reported attitudes towards SDM. They concluded that healthcare professionals generally express a positive attitude towards SDM, but in practice (mainly due to clinical scenario, treatment decision, and patient characteristics) they often do not perform SDM.…”

Section: Current Implementation Of Sdmmentioning

confidence: 99%

“…Some studies mention indirectly influencing stakeholders, such as physician mentors (of junior physicians) in particular when these do not support the use of SDM (Pollard, Bansback, and Bryan 2015). Other target groups, such as decision partners, i.e.…”

Section: Value Of Design Research Compared To Health Services Researchmentioning

confidence: 99%

“…Treatment decision-making by patients and healthcare professionals can be complex, in particular when there are more treatments available with different risk profiles, potential outcomes, and effects on survival and quality of life (Pollard, Bansback, and Bryan 2015). Shared decision-making (SDM) is considered a promising way to address problems associated with this complexity, by proposing that patient and physician exchange information, discuss pros and cons, and come to an agreement on the treatment (Stiggelbout, Pieterse, and De Haes 2015).…”

Section: Introductionmentioning

confidence: 99%

“…Although SDM is gaining worldwide attention and acceptance, implementation of SDM is still limited (Cou€ et et al 2015;Durand et al 2015;Stiggelbout, Pieterse, and De Haes 2015) despite the fact that many causes of the current limited implementation have been uncovered (Legare et al 2008;Pollard, Bansback, and Bryan 2015;Joseph-Williams, Elwyn, and Edwards 2014). To face the informational, social, and ethical complexities connected with the implementation of SDM, this paper proposes a service design perspective on SDM, to complement extant knowledge about, and approaches towards, improving the implementation of SDM.…”

Section: Introductionmentioning

confidence: 99%

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The potential of service design for improving the implementation of shared decision-making

et al. 2017

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This paper addresses the potential contribution of service design for improving the implementation of shared decisionmaking in healthcare. The iterative approach of design research is compared with the more linear, (social) scientific approaches often seen in health services research. Five foundational principles of service design are explored regarding their potential contribution to the improvement of the implementation of shared decision-making. Thus, this position paper can be seen as a call on service designers and healthcare professionals to combine their efforts to improve the implementation of shared decision-making in healthcare.

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Section: Current Implementation Of Sdmmentioning

confidence: 99%

Section: Value Of Design Research Compared To Health Services Researchmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The potential of service design for improving the implementation of shared decision-making

et al. 2017

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“…Here, we adopt the definition of shared decision-making (SDM) proposed by Charles et al (1), wherein a truly shared approach consists of both physician and patient involvement in the process of information exchange, expression of treatment preferences, and agreement on the treatment plan. Shared decision-making is appropriate when applied to nonemergent 'preference-sensitive' treatment scenarios, where multiple therapeutic options exist, and where individual patient values, preferences, goals, and lifestyle choices play an important role in deciding upon a particular treatment (1,(3)(4)(5). Specifically in clinical scenarios where ongoing self-management of chronic illness is required on the part of the patient, satisfaction and treatment acceptance may be particularly important outcomes of the decision-making process (5).…”

mentioning

confidence: 99%

The burden of nonadherence among adults with asthma: a role for shared decision‐making

Pollard

Bansback

FitzGerld

et al. 2017

Allergy

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To cite this article: Pollard S, Bansback N, FitzGerld JM, Bryan S. The burden of nonadherence among adults with asthma: a role for shared decision-making. AbstractA shared approach to decision-making framework has been suggested for chronic disease management especially where multiple treatment options exist. Shared decision-making (SDM) requires that both physician and patients are actively engaged in the decision-making process, including information exchange; expressing treatment preferences; as well as agreement over the final treatment decision. Although SDM appears well supported by patients, practitioners and policymakers alike, the current challenge is to determine how best to make SDM a reality in everyday clinical practice. Within the context of asthma, adherence rates are poor and are linked to outcomes such as reduced asthma control, increased symptoms, healthcare expenditures, and lower patient quality of life. It has been suggested that SDM can improve treatment adherence and that ignoring patients' personal goals and preferences may result in reduced rates of adherence. Furthermore, understanding predictors of poor treatment adherence is a necessary step toward developing effective strategies to improve the patient-reported and clinically important outcomes. Here, we describe why a shared approach to treatment decision-making for asthma has the potential to be an effective tool for improving adherence, with associated clinical and patient-related outcomes. In addition, we explore insights into the reasons why SDM has not been implemented into routine clinical practice.

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Sliding-Scale Shared Decision Making for Patients With Reduced Capacity

Lahey

Elwyn

2020

AMA Journal of Ethics

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Shared decision making honors patient autonomy, particularly for preference-sensitive care decisions. Shared decision making can be challenging, however, when patients have impaired decision-making capacity. Here, after presenting an illustrative case example, this paper proposes a capacity-adjusted "sliding scale" approach to shared decision making. CaseDr Q is an academic hepatologist meeting a new patient, Mr R, for newly diagnosed cirrhosis. The patient has clear signs of liver dysfunction and has already been admitted to the hospital previously for a gastrointestinal bleed related to esophageal varices. He also has chronic obstructive pulmonary disease, obesity, and poorly controlled type 2 diabetes mellitus.Dr Q and her student, Ms G, interview and examine Mr R together. They learn that Mr R did not complete high school and lives on what he calls "the wrong side of the tracks." He lives alone and drinks 4 beers daily. He thinks his brother might have had "liver problems," too.As the conversation unfolds, it becomes clear that Mr R does not know why he's in clinic today. "My doc said it was something about my liver, but…" He shrugs.Ms G and Dr Q teach Mr R about cirrhosis. They emphasize the importance of alcohol abstinence and start to explain that further workup is necessary-including, potentially, a liver biopsy. Their goal is to enter into shared decision making with Mr R about liver biopsy. Mr R holds up his hand midway through their explanation and says, "I'm not a detail guy, Doc. I trust you. You tell me what to do, and I'll do it." They talk more, and, ultimately, Dr Q asks, "Do you have any questions for me?" Mr R pauses for a second, starts to ask a question, and then tapers off. 1 Finally, he says, "Whatever you say, Doc. I'm in your hands."

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Physician attitudes toward shared decision making: A systematic review

Cited by 190 publications

References 63 publications

The potential of service design for improving the implementation of shared decision-making

The potential of service design for improving the implementation of shared decision-making

The burden of nonadherence among adults with asthma: a role for shared decision‐making

Sliding-Scale Shared Decision Making for Patients With Reduced Capacity

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