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Systematic Review

17 November 2017

Patient and provider perspectives on shared decision making: a systematic review of the peer-reviewed literature

Authors: Nyna Williams [email protected], Chris Fleming, and Annie DoubledayAuthor Info & Affiliations

Publication: J. Comp. Eff. Res.

Volume 6, Number 8

https://doi.org/10.2217/cer-2017-0045

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Abstract

For comparative effectiveness research to be effective, patients and providers must collaborate in shared decision making (SDM) to make evidence-based clinical decisions that align with patient preferences. We conducted a systematic review to examine patient and provider attitudes toward and engagement in SDM in the USA. Searches in PubMed and PsycINFO identified 1585 articles published between July 2006 and December 2016, of which 290 were screened in for coding and analysis. We found that patients and providers have generally positive attitudes toward SDM, but actual engagement in SDM behavior is lagging. Translation of positive attitudes into behavior could be achieved through policies that support key SDM processes of sharing evidence, considering patient preferences and discussing the relative advantages of different clinical options.

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References

Papers of special note have been highlighted as: • of interest; •• of considerable interest

1.

Institute of Medicine. Initial National Priorities For Comparative Effectiveness Research. National Academies Press, DC, USA (2009).

• Mandated by the American Recovery and Reinvestment Act of 2009, this report obtained input from diverse stakeholders (including patients and providers) regarding comparative effectiveness research priorities.

2.

Federal Coordinating Council for Comparative Effectiveness Research. Report to the President and the Congress. US Department of Health and Human Services, DC, USA (2009). https://osp.od.nih.gov/wp-content/uploads/FCCCER-Report-to-the-President-and-Congress-2009.pdf.

• Mandated by the American Recovery and Reinvestment Act of 2009, this report obtained input from diverse stakeholders (including patients and providers) regarding comparative effectiveness research recommendations.

3.

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4.

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5.

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•• Highlights the importance of shared decision making (SDM) for ensuring patient-centered healthcare and provides recommendations for promotion of SDM by patients and providers.

6.

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•• Highlights the importance of SDM for improving healthcare quality and reducing costs and provides recommendations for promotion of SDM by federal health programs and agencies.

7.

Gerteis M, Borck R. Shared decision-making in practice: lessons from implementation efforts. Report Submitted to the Medicare Payment Advisory Commission. Mathematica Policy Research, MA, USA (2009).

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8.

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9.

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11.

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12.

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16.

Barr PJ, Forcino RC, Mishra M, Blitzer R, Elwyn G. Competing priorities in treatment decision-making: a US national survey of individuals with depression and clinicians who treat depression. BMJ Open 6, e009585 (2016).

• Study showing relatively low levels of SDM among patients with depression, with somewhat higher levels for psychiatrist providers.

17.

Fairfield KM, Gerstein BS, Levin CA, Stringfellow V, Wierman HR, McNaughton-Collins M. Decisions about medication use and cancer screening across age groups in the United States. Patient Educ. Couns. 98(3), 338–343 (2015).

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18.

Barry MJ, Wexler RM, Brackett CD et al. Responses to a decision aid on prostate cancer screening in primary care practices. Am. J. Prev. Med. 49(4), 520–525 (2015).

19.

Hoffman RM, Elmore JG, Pignone MP, Gerstein BS, Levin CA, Fairfield KM. Knowledge and values for cancer screening decisions: results from a national survey. Patient Educ. Couns. 99(4), 624–630 (2016).

• Study finding relatively low levels of knowledge regarding cancer screening and overestimation of lifetime risk of cancer incidence and mortality.

20.

Marrie RA, Salter AR, Tyry T, Fox RJ, Cutter GR. Preferred sources of health information in persons with multiple sclerosis: degree of trust and information sought. J. Med. Internet Res. 15(4), 210–221 (2013).

21.

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•• Study showing that primary care provider beliefs about screening are associated with use of SDM with patients.

22.

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23.

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• Randomized controlled trial showed that SDM intervention increased likelihood of patient reaching an informed decision during first visit.

24.

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