Results from a pragmatic prospective cohort study: Shared decision making improves outcomes for children with asthma

Abstract

The evidence-based SDM intervention implemented in this study was associated with improved asthma outcomes for pediatric patients but not adult patients in a real world clinical setting.

Preference Phenotypes in Support of Shared Decision–Making at Point‐of‐Care for Patients With Rheumatoid Arthritis: A Proof‐of‐Concept Study

“…Elwyn et al described a practical 3‐step model for shared decision‐making: create awareness that a choice exists (i.e., choice talk), provide decision support through discussion of options, including pros and cons (i.e., option talk), and discuss patient values and/or preferences and arrive at a shared decision (i.e., decision talk). Shared decision‐making improves patient‐physician communication, increases patient satisfaction, and enables patients to feel more empowered to make difficult decisions, which can result in more favorable health outcomes . Still, patient preferences for participating in decision‐making vary, with some preferring to defer all responsibility to their physician and others viewing themselves as the primary decision makers .…”

Evaluation of a shared decision-making intervention for pediatric patients with asthma in the emergency department

“…From earlier work, we demonstrated that a facilitated approach to implementation of SDM was associated with improved perceptions of SDM and improved ED utilization for pediatric patients [17,18,[27][28][29]. Identified implementation barriers included time constraints of the clinical team in a volume-based reimbursement structure, staff turnover, and lack of availability of staff to train as health coaches.…”

“…Shared decision making (SDM) is an approach where patients and providers come together to determine the best plan of care based on evidence and patient preferences [17]. Previous studies show that SDM in primary care is associated with improved outcomes for pediatric patients with asthma [12,[17][18][19][20]. Implementation and dissemination have been highlighted as a key national priority by the Patient-Centered Outcomes Research Institute (PCORI), the Agency for Healthcare Research and Quality (AHRQ), and the Institute of Medicine (IOM) [21][22][23].…”

Asthma dissemination around patient-centered treatments in North Carolina (ADAPT-NC): a cluster randomized control trial evaluating dissemination of an evidence-based shared decision-making intervention for asthma management

“…In the ambulatory setting, newer approaches to treatment, such as shared decision making (SDM), have shown improved outcomes for patients with asthma [5,6]. However, the dissemination of such complex interventions has been slow or inconsistent [7].…”

“…An asthma action plan is prepared that incorporates the jointly agreed-upon treatment decisions. Improved outcomes for children with asthma were seen at six practices that previously adopted the SDM toolkit intervention using this facilitator-led approach [5].…”