Shared decision-making between health care providers and patients at a tertiary hospital diabetic Clinic in Tanzania

Vedasto, Osward; Morris, Baraka; Fredrick, Francis

doi:10.1186/s12913-020-06041-4

Cited by 17 publications

(10 citation statements)

References 27 publications

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“…In the present study, a significant mean difference was observed in the intervention group because there are no family planning decision aids in antenatal clinics to help patients decide on the family planning option that they would take. A study on the experiences of diabetic patients and healthcare providers on shared decision-making conducted in Tanzania found that neither the patients nor the healthcare providers had been using decision-making aids; the patients reported that only health education tools are being used for educating them [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

A Decision Aid for Postpartum Adolescent Family Planning: A Quasi-Experimental Study in Tanzania

Mushy

Horiuchi

Shishido

2023

IJERPH

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Background: We evaluated the effects of our postpartum Green Star family planning decision aid on the decisional conflict, knowledge, satisfaction, and uptake of long-acting reversible contraception among pregnant adolescents in Tanzania. Methods: We used a facility-based pre–post quasi-experimental design. The intervention arm received routine family planning counseling and the decision aid. The control received only routine family planning counseling. The primary outcome was the change in decisional conflict measured using the validated decision conflict scale (DCS). The secondary outcomes were knowledge, satisfaction, and contraception uptake. Results: We recruited 66 pregnant adolescents, and 62 completed this study. The intervention group had a lower mean score difference in the DCS than in the control (intervention: −24.7 vs. control: −11.6, p < 0.001). The mean score difference in knowledge was significantly higher in the intervention than in the control (intervention: 4.53 vs. control: 2.0, p < 0.001). The mean score of satisfaction was significantly higher in the intervention than in the control (intervention: 100 vs. control: 55.8, p < 0.001). Contraceptive uptake was significantly higher in the intervention [29 (45.3%)] than in the control [13 (20.3%)] (p < 0.001). Conclusion: The decision aid demonstrated positive applicability and affordability for pregnant adolescents in Tanzania.

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Section: Discussionmentioning

confidence: 99%

A Decision Aid for Postpartum Adolescent Family Planning: A Quasi-Experimental Study in Tanzania

Mushy

Horiuchi

Shishido

2023

IJERPH

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“…This complements findings from other developing countries that have reported low patients' participation in decision making during their treatment. [21][22][23] In Uganda, a study among breast cancer patients showed that 80% of them were not given a chance to participate in the selection of their treatment options. 11 However, higher participation in SDM has been reported in some developed countries.…”

Section: Discussionmentioning

confidence: 99%

“…In a study in Tanzania, healthcare workers admitted that patients with low education status found it harder to comprehend medical information, and therefore making it difficult to engage them in SDM. 23 In a qualitative study in Australia, participants with a higher level of education perceived getting involved as a shared responsibility with healthcare providers throughout the process of decision making. This included verifying information provided by the healthcare providers as well as discovering treatment options outside those presented to them by the health workers.…”

Section: Discussionmentioning

confidence: 99%

Patients’ Involvement in Decision-Making During Healthcare in a Developing Country: A Cross-Sectional Study

Nuwagaba¹,

Olum²,

Bananyiza³

et al. 2021

PPA

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Patient autonomy and participation have a significant impact on patient satisfaction and compliance with treatment. We aimed to establish and describe the level of shared decision-making (SDM) among the patients in a developing country. Uganda is a low resource country with a 2019 GDP of 35.17 billion US dollars. In some regions, over 60% of Ugandans live below the national poverty line and most of them depend on the underfunded health care system. Methods: A cross-sectional, quantitative study was carried out among the outpatients attending Kisenyi Health center IV, Kampala, Uganda. An interviewer-administered questionnaire with a 5-point Likert scale was used to assess patients' SDM. All statistical analysis was performed using STATA 15 software. Results: A total of 326 patients participated in this study. Majority of the participants were females (n=241, 73.9%) and aged 18-35 years (n=218, 66.9%). Only 22 (7%) of the participants knew the name of their consulting doctor. Most of the participants, 84% were given enough time to narrate their symptoms. Overall, only 11.3% (n=37) of the participants had adequately participated in SDM. The overall mean score of participation in SDM was 2.7 (SD:0.8). Participants who knew the name of their consulting doctor were approximately 11 times more likely to participate in SDM (OR: 10.7, 95% CI: 4.2-27.0, P<0.0001). Conclusion:The majority of patients attending Kisenyi Health Center IV did not adequately participate in SDM. Continued medical education should be organized for healthcare professionals to promote SDM.

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“…One strategy to relieve prescribing pressures involves embracing shared decision making (SDM) in patient care and sharing your clinical reasoning with patients. Prior studies of SDM in African health settings have identified a lack of decision aids/tools as an important barrier to effective SDM [ 26 ]. Where possible, providers should try to supply their patients with culturally and education-level-appropriate materials during SDM conversations.…”

Section: Strategies For African Providers and Public Health Practitionersmentioning

confidence: 99%

Polypharmacy Exposure, Aging Populations, and COVID-19: Considerations for Healthcare Providers and Public Health Practitioners in Africa

Nwanaji‐Enwerem

Boyer

Olufadeji

2021

IJERPH

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Given the continent’s growing aging population and expanding prevalence of multimorbidity, polypharmacy is an increasingly dire threat to the health of persons living in Africa. The COVID-19 pandemic has only exacerbated these issues. Widespread misinformation, lack of vaccine access, and attempts to avoid being infected have resulted in increases in Africans’ willingness to take multiple prescription and nonprescription medications and supplements. Issues with counterfeit pharmaceuticals and the relatively new recognition of emergency medicine as a specialty across the continent also create unique challenges for addressing this urgent public health need. Experts have called for more robust pharmaceutical regulation and healthcare/public health infrastructure investments across the continent. However, these changes take time, and more near-term strategies are needed to mitigate current health needs. In this commentary, we present a nonexhaustive set of immediately implementable recommendations that can serve as local strategies to address current polypharmacy-related health needs of Africans. Importantly, our recommendations take into consideration that not all healthcare providers are emergency medicine trained and that local trends related to polypharmacy will change over time and require ever-evolving public health initiatives. Still, by bolstering training to safeguard against provider availability biases, practicing evidence-based prescribing and shared decision making, and tracking and sharing local trends related to polypharmacy, African healthcare providers and public health practitioners can better position themselves to meet population needs. Furthermore, although these recommendations are tailored to Africans, they may also prove useful to providers and practitioners in other regions facing similar challenges.

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Shared decision-making between health care providers and patients at a tertiary hospital diabetic Clinic in Tanzania

Cited by 17 publications

References 27 publications

A Decision Aid for Postpartum Adolescent Family Planning: A Quasi-Experimental Study in Tanzania

A Decision Aid for Postpartum Adolescent Family Planning: A Quasi-Experimental Study in Tanzania

Patients’ Involvement in Decision-Making During Healthcare in a Developing Country: A Cross-Sectional Study

Polypharmacy Exposure, Aging Populations, and COVID-19: Considerations for Healthcare Providers and Public Health Practitioners in Africa

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