Shared decision making in rheumatology: A scoping review

Morrison, Tessalyn; Foster, Erin; Dougherty, Jacob; Barton, Jennifer L.

doi:10.1016/j.semarthrit.2022.152041

Cited by 27 publications

(13 citation statements)

References 81 publications

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“…22,23 Therefore, it is very important to actively include patients in therapeutic decisions. 24 Patient satisfaction affects adherence to treatment, engagement in self-care, and overall quality of life. Taking into account patient´s satisfaction, physicians and healthcare professionals can improve the patient–physician relationship and provide better patient care.…”

Section: Discussionmentioning

confidence: 99%

Satisfaction and effectiveness of switching from intravenous to subcutaneous belimumab treatment in daily clinical practice

Frade-Sosa,

Salman-Monte,

Narváez

et al. 2024

Lupus

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Background In 2017, belimumab (BEL) was approved in subcutaneous (SQ) administration. The effectiveness after switching from intravenous (IV) to SQ and patient satisfaction in daily clinical practice has not been studied. During the pandemic, patient follow-up and treatment were significantly affected, and some patients need a change from IV to SQ. Our aim was to evaluate daily clinical practice satisfaction to SQ BEL therapy in patients previously treated IV BEL. We hypothesized that SQ BEL in SLE patients previously treated with IV BEL was similar in effectiveness and conferred higher satisfaction. Methods Observational, multicenter study, conducted in 7 reference centers in Catalonia. We included stable SLE patients (EULAR/ACR 2019) on treatment with SQ BEL and previous use of IV BEL (at least 3 months on IV BEL before switching). Since there are no well-validated tools for SQ BEL treatment satisfaction, we used RASQ-SQ, validated in patients with lymphoma who switched from IV Rituximab to SQ treatment, and modified for BEL treatment. Results Twenty-seven patients were included. The more prevalent clinical manifestations observed were related to the skin and joints and the patients had a mean baseline SLEDAI of 2.96 (SD 2.4) and SLICC score of 0.67 (SD 0.88). The median time from treatment with IV BEL before switching to SQ was 21 months (range). 84% of patients reported confidence in SQ BEL. 85.2% felt that treatment with SQ BEL was convenient or very convenient. 85% felt they had gained time with the change. 89% would recommend the SQ injection to other patients. Disease activity (mean SLEDAI) and remission rates remain stable after switching. No major new adverse effects were reported. Conclusions Overall satisfaction, satisfaction with via of administration, and satisfaction with the time taken to receive BEL were higher for SQ BEL treatment. A switching SQ strategy is a reasonable alternative for BEL patients.

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Section: Discussionmentioning

confidence: 99%

Satisfaction and effectiveness of switching from intravenous to subcutaneous belimumab treatment in daily clinical practice

Frade-Sosa,

Salman-Monte,

Narváez

et al. 2024

Lupus

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“…There is conflicting evidence regarding the impact of patient gender. The previously mentioned NARCOMS Registry study of patients with MS, as well as two scoping reviews of 74 and eight articles in surgery and rheumatology, respectively, found women favored SDM more than men, who preferred physician-based decision-making (i.e., HCP makes final, or all, decisions on treatment) [ 10 , 34 , 35 ]. In contrast, a meta-analysis of 775 clinical encounters in seven USA-based randomized trials across several diseases found no significant difference in SDM between gender dyads, suggesting male gender may not act as a barrier to SDM [ 36 ].…”

Section: Clinical Experience Of Sdm In Msmentioning

confidence: 99%

“…Studies suggest that patient age could influence SDM preferences. Two scoping reviews, one of 74 studies in surgery and one of 12 studies in rheumatology, found younger patients had higher SDM preference or satisfaction, although a threshold for “younger” was not provided by these reviews [ 34 , 35 ]. Analyses of data from the NARCOMS Registry showed younger patients preferred patient-centered decision-making, whereas older patients preferred SDM or physician-centered decision-making [ 10 ], suggesting a gradual decline in desired autonomy over a patient’s life span, generational differences in older patients accustomed to the paternalistic approach to medicine, or a greater propensity for younger patients to research their disease and treatment options online.…”

Section: Clinical Experience Of Sdm In Msmentioning

confidence: 99%

Insights for Healthcare Providers on Shared Decision-Making in Multiple Sclerosis: A Narrative Review

Stoll,

Costello,

Newsome

et al. 2024

Neurol Ther

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Shared decision-making (SDM) between the patient and their healthcare provider (HCP) in developing treatment plans is increasingly recognized as central to improving treatment adherence and, ultimately, patient outcomes. In multiple sclerosis (MS), SDM is particularly crucial for optimizing treatment in a landscape that has grown more complex with the availability of newer, high-efficacy MS therapies. However, little direct evidence on the effectiveness of SDM is available to guide practice. Multiple factors, including patient age, ethnic background, perceptions, invisible MS symptoms, and psychological comorbidities can influence a patient’s willingness and ability to participate in SDM. HCPs need to appreciate these factors and ask the right questions to break down obstacles to SDM. The HCP has a responsibility to help patients feel adequately informed and comfortable in having an active role in their care. This review identifies potential barriers to SDM and provides a strategy for HCPs to overcome these obstacles through patient (and caregiver) discussions to ensure optimal patient satisfaction with treatment and thus the best possible outcomes for their patients.

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“…Although AI has positively impacted various aspects of TCM research, it is essential to consider the human aspect of TCM services since the recipients of TCM care are human beings. Shared decision making (SDM), as an important approach to bridge the gap in evidence-based medical practice, places the “patient at the center” and encourages patients to participate in discussions about their diagnosis, treatment, and follow-up, thereby facilitating the development of personalized clinical decisions that best suit the patient’s needs ( 28 , 29 ). The influence of AI on SDM remains unclear, and its application comes with various risks and challenges.…”

Section: Introductionmentioning

confidence: 99%

Opportunities and challenges of traditional Chinese medicine doctors in the era of artificial intelligence

Li,

Ge,

Liu

et al. 2024

Front. Med.

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With the exponential advancement of artificial intelligence (AI) technology, the realm of medicine is experiencing a paradigm shift, engendering a multitude of prospects and trials for healthcare practitioners, encompassing those devoted to the practice of traditional Chinese medicine (TCM). This study explores the evolving landscape for TCM practitioners in the AI era, emphasizing that while AI can be helpful, it cannot replace the role of TCM practitioners. It is paramount to underscore the intrinsic worth of human expertise, accentuating that artificial intelligence (AI) is merely an instrument. On the one hand, AI-enabled tools like intelligent symptom checkers, diagnostic assistance systems, and personalized treatment plans can augment TCM practitioners’ expertise and capacity, improving diagnosis accuracy and treatment efficacy. AI-empowered collaborations between Western medicine and TCM can strengthen holistic care. On the other hand, AI may disrupt conventional TCM workflow and doctor-patient relationships. Maintaining the humanistic spirit of TCM while embracing AI requires upholding professional ethics and establishing appropriate regulations. To leverage AI while retaining the essence of TCM, practitioners need to hone holistic analytical skills and see AI as complementary. By highlighting promising applications and potential risks of AI in TCM, this study provides strategic insights for stakeholders to promote the integrated development of AI and TCM for better patient outcomes. With proper implementation, AI can become a valuable assistant for TCM practitioners to elevate healthcare quality.

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Shared decision making in rheumatology: A scoping review

Cited by 27 publications

References 81 publications

Satisfaction and effectiveness of switching from intravenous to subcutaneous belimumab treatment in daily clinical practice

Satisfaction and effectiveness of switching from intravenous to subcutaneous belimumab treatment in daily clinical practice

Insights for Healthcare Providers on Shared Decision-Making in Multiple Sclerosis: A Narrative Review

Opportunities and challenges of traditional Chinese medicine doctors in the era of artificial intelligence

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