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

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

doi:10.1002/14651858.cd006732.pub2

Cited by 517 publications

(380 citation statements)

References 78 publications

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“…Training to enhance SDM skill in clinicians may be effective [22]; however, there is paucity of practical guidance with respect to accomplishing SDM practice and evidence shows that without practical interventions, most clinicians do not consistently implement it [14]. Clinicians may wish to audio-record consultations with patients' permission and score these, using the OPTION scale which would enable the prevalence of SDM to be measured as a self-directed learning or professional development activity.…”

Section: Discussionmentioning

confidence: 99%

Shared decision-making in back pain consultations: an illusion or reality?

Jones

Roberts

Little³

et al. 2014

Eur Spine J

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Purpose Amid a political agenda for patient-centred healthcare, shared decision-making is reported to substantially improve patient experience, adherence to treatment and health outcomes. However, observational studies have shown that shared decision-making is rarely implemented in practice. The purpose of this study was to measure the prevalence of shared decision-making in clinical encounters involving physiotherapists and patients with back pain.Method Eighty outpatient encounters (comprising 40 h of data) were observed audio-recorded, transcribed verbatim and analysed using the 12-item OPTION scale. The higher the score, the greater is the shared decision-making competency of the clinicians. Results The mean OPTION score was 24.0 % (range 10.4-43.8 %). Conclusion Shared decision-making was under-developed in the observed back pain consultations. Clinicians' strong desire to treat acted as a barrier to shared decisionmaking and further work should focus on when and how it can be implemented.

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Section: Discussionmentioning

confidence: 99%

Shared decision-making in back pain consultations: an illusion or reality?

Jones

Roberts

Little³

et al. 2014

Eur Spine J

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“…Evidence to support these objections is slim. Although consultation length varies depending on the context, no-one has yet proved that SDM systematically takes longer [37][38][39]. Models for interprofessional SDM have been developed and are being tested [40,41].…”

Section: Evidence Of Risks and Benefitsmentioning

confidence: 99%

Is Shared Decision Making a Utopian Dream or an Achievable Goal?

Blair

2015

Patient

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The idea of shared decision making (SDM) between patient and physician grew out of a generalized challenge to traditional social hierarchies that occurred in the middle of the last century. Governments have espoused SDM, thousands of articles about it have been published, and evidence has shown that it improves some of the healthcare processes as well as patient outcomes. Yet it has not been widely adopted. From their cross-disciplinary perspective (practical theology and clinical medicine), the authors locate this reluctance in the unfolding of scientific paradigm shifts, summarize the perceived risks and benefits of SDM and the evidence for each, and suggest practical, achievable approaches for clinicians. Finally, they explore some important emerging territories for SDM. Key Points for Decision MakersShared decision making (SDM) has proved its worth and is achievable … but debates continue.Several validated models are available right now for use in clinical practice.People can and are being successfully trained in SDM.SDM is needed to address emerging value-laden clinical decisions such as those about caring for the elderly and about genetic testing.

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“…Studies investigating the implementation of SDM interventions in somatic care have primarily taken place in the U.S.A. and the UK (Elwyn et al, 2012; Kashaf, McGill, & Berger, 2017; Légaré et al, 2010; Woodhouse et al, 2017). While few in number, implementation studies on SDM interventions in Sweden have suggested the importance of expanding the decision-making process beyond single encounters (Hultberg & Rudebeck, 2017) and beyond simply educating the patient in self-care (Herlitz, Munthe, Törner, & Forsander, 2016).…”

Section: Introductionmentioning

confidence: 99%

“…SDM has only been implemented to a limited extent in Sweden and other Scandinavian countries (Légaré et al, 2014), despite the fact that SDM is one of the interventions recommended by the National Board of Health and Welfare in the Swedish Guidelines for Psychosocial Interventions for Schizophrenia or Schizophrenia-type conditions (2011/2017). While these recommendations are primarily based on evidence from Anglo-Saxon practice, the development and dissemination of new methods for psychosocial support have rapidly changed the field of community mental health in Sweden.…”

Section: Introductionmentioning

confidence: 99%

Psychiatric service staff perceptions of implementing a shared decision-making tool: a process evaluation study

Schön

Grim

Wallin

et al. 2018

International Journal of Qualitative Studies on Health and Well

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Purpose: Shared decision making, SDM, in psychiatric services, supports users to experience a greater sense of involvement in treatment, self-efficacy, autonomy and reduced coercion. Decision tools adapted to the needs of users have the potential to support SDM and restructure how users and staff work together to arrive at shared decisions.The aim of this study was to describe and analyse the implementation process of an SDM intervention for users of psychiatric services in Sweden. Method: The implementation was studied through a process evaluation utilizing both quantitative and qualitative methods. In designing the process evaluation for the intervention, three evaluation components were emphasized: contextual factors, implementation issues and mechanisms of impact. Results: The study addresses critical implementation issues related to decision-making authority, the perceived decision-making ability of users and the readiness of the service to increase influence and participation. It also emphasizes the importance of facilitation, as well as suggesting contextual adaptations that may be relevant for the local organizations. Conclusion: The results indicate that staff perceived the decision support tool as user-friendly and useful in supporting participation in decision-making, and suggest that such concrete supports to participation can be a factor in implementation if adequate attention is paid to organizational contexts and structures.

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

Cited by 517 publications

References 78 publications

Shared decision-making in back pain consultations: an illusion or reality?

Shared decision-making in back pain consultations: an illusion or reality?

Is Shared Decision Making a Utopian Dream or an Achievable Goal?

Psychiatric service staff perceptions of implementing a shared decision-making tool: a process evaluation study

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