The Role of Shared Decision-Making in Personalised Medicine: Opening the Debate

Guadalajara, Héctor; Lopez-Fernandez, Olatz; Arellano, Miguel León; Domínguez-Prieto, Víctor; Caramés, Cristina; García-Olmo, Damián

doi:10.3390/ph15020215

Cited by 8 publications

(8 citation statements)

References 28 publications

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“…At the same time the benefits of Precision/Personalized Medicine and the major obstacles for all stakeholders involved are summarized as well as specific solutions are provided. Knowledge and perception of Medical and Pharmacy students towards Pharmacogenomics and Genetics is also presented [6, 8–10, 22, 27–29, 33, 34, 45, 51, 53–55, 59, 67, 74–77, 81–83, 85–107, 112, 113, 121].…”

Section: Resultsmentioning

confidence: 99%

Advancing precision medicine in medical education: Integrated, precise and data‐driven smart solutions

Papadopoulou

Lytras

2023

Applied Research

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Advances in “Precision Medicine” initiative, also known as “Personalized Medicine” is an emerging approach for disease treatment and prevention that has already led to innovative discoveries and has created “smart” applications and solutions tailored to a person's or a group of individuals' genetic profile, lifestyle, and environment interaction. Already many physicians as part of patient care routinely prescribe various molecular/genetic and other tests enabling them to select personalized treatments that improve the chances of survival and reduce exposure to adverse effects. This initiative should provide to medical and healthcare professionals with adequate resources and readily available solutions so that the target to specific treatments and care of the illnesses is achieved while at the same time protecting the privacy and safety of the individual is secured as well as the Electronic Health Records (EHRs) and whatever additional data is necessary within the context of Precision Medicine. This study, through a literature review mostly, and some case study analysis, examine whether personalized medicine is delivered to the patient in an “accurate” and “precise” way, as expected. This requires that Health and Human Services and other stakeholders and agencies collaborate to solicit the right input from patients while at the same time can identify and address any educational, practical, legal, and technical issues and providing smart solutions. The lack of proper medical education and advanced infrastructure are still major barriers to the adoption of Precision Medicine, therefore, the role of medical training in Precision Medicine is also examined and analyzed. Specific examples are discussed in an integrated, precise, and data‐driven manner to provide “smart” solutions.

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Section: Resultsmentioning

confidence: 99%

Advancing precision medicine in medical education: Integrated, precise and data‐driven smart solutions

Papadopoulou

Lytras

2023

Applied Research

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“…Previous research on shared decision-making yields conflicting evidence regarding its potential benefits, with some studies suggesting positive associations with patient satisfaction and health outcomes (Bomhof-Roordink et al, 2019; Entwistle, 2004; Entwistle et al, 2012; Josfeld et al, 2021), while others express scepticism about its practical application (Gillman & Ferrer, 2021; Guadalajara et al, 2022; Ozdemir & Finkelstein, 2018). In this study, experimental conditions of shared decision-making were found to be linked to heightened trust, reduced emotional distress, and increased patient agency.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, those in borderline anxiety group reported that ‘not understanding the reasons for the medical team’s care decisions contributed to their distress’ (Blok et al, 2023, p. 26). Such studies suggest that since shared decision-making promotes open communication (Guadalajara et al, 2022), there is an increased patients’ and family caregivers’ participation in the treatment process (Lincoln et al, 2023) and lower treatment anxiety (Blok et al, 2023).…”

Section: Discussionmentioning

confidence: 99%

“…The present study identified four core aspects of the decision process: trust in doctors, patient’s agency, emotional distress and attribution of responsibility. Previous literature suggests that as shared decision-making acknowledges patients’ autonomy (Guadalajara et al, 2022; Lantos, 2021), it fosters greater trust in doctors for both patients and caregivers (Entwistle, 2004; Lincoln et al, 2023) and elicits higher patient satisfaction (Oprea et al, 2023; Pollard et al, 2015). Financial toxicity is also found to be linked to higher emotional distress (Abrams et al, 2021; Carrera et al, 2018), lower agency in decision process (Boby et al, 2021; Prinja et al, 2023) and higher trust in doctors (Abrams et al, 2021; Boby et al, 2021; Zafar & Peppercorn, 2023).…”

Section: Core Aspects Of Decision Processmentioning

confidence: 99%

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Exploring the Influence of Decisionmaking Style and Financial Status of Cancer Patients on Varied Cultural Aspects of Decision Process

Jain,

Singh

2024

Psychology and Developing Societies

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Though many studies have linked shared decision-making with positive patient outcomes and patient satisfaction, there is less research on the practicality and feasibility of such an approach, specifically, in India. Recent findings indicate that contextual constraints of the patients and family caregivers are fused with and inevitably shape their decision-making style. This study investigates the influence of individual (paternalistic and shared decision-making style) and contextual (financial status of the patients) factors on certain cultural aspects of decision process, namely, trust in doctors, patient’s agency, emotional distress and attribution of responsibility. Data were collected using a survey questionnaire from a sample of 306 participants. Linear mixed models were used to analyse the responses. The results indicate that a shift towards shared approaches does yield qualitatively superior outcomes in terms of increased trust in doctors and patients’ agency along with reduced emotional distress. The study also emphasises the role of cultural metaphysical beliefs in attributing responsibility for treatment decisions. Further, low financial status was found to be associated with higher trust in doctors, lower patient agency, and increased emotional distress for both patients and family caregivers. The move towards shared decision-making, considering the contextual realities of patients, could be instrumental in addressing critical issues, such as prevalence of collusion, superficial role of informed consent, and high reliance on doctors’ authority or expertise.

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“…If patients (and their families or community) take over (some) responsibility to self-manage their health, scarce healthcare resources can be invested to treat more complex conditions. The shared decision-making model goes hand in hand with the shift to a more open mindset in healthcare (Guadalajara et al ., 2022).…”

Section: Introductionmentioning

confidence: 99%

The role of open innovation in addressing resource constraints in healthcare: a systematic literature review

Šlapáková Losová,

Dvouletý

2024

JHOM

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PurposeThe resource crisis in healthcare can be alleviated by engaging external stakeholders and resources in healthcare delivery. The authors use value and open innovation concepts to understand what motivates the stakeholders to join the healthcare innovation ecosystem and what value such an ecosystem brings to healthcare.Design/methodology/approachA systematic literature review following the PRISMA framework method was applied to reach the research objective. Out of a total of 509 identified articles published till 2021, 25 were selected as relevant for this review.FindingsSix categories of actors were identified, including innovation intermediaries, which were so far neglected in the healthcare innovation literature. Furthermore, patients, healthcare providers, innovation suppliers, investors and influencers were described. The authors also distinguished internal and external stakeholders. The authors show why and how open innovation projects contribute to involving external stakeholders and resources in healthcare delivery by contributing to patient autonomy, relationship building, knowledge transfer, improving collaborative mindset and culture, advancing know-how and bringing additional finances.Originality/valueThis article is the first one to systematically describe the value of open innovation in healthcare. The authors challenge the positivist approach in value presented by value-based healthcare. The authors show how openness contributes to addressing the resource crisis by involving new stakeholders and resources in the care delivery process.

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The Role of Shared Decision-Making in Personalised Medicine: Opening the Debate

Cited by 8 publications

References 28 publications

Advancing precision medicine in medical education: Integrated, precise and data‐driven smart solutions

Advancing precision medicine in medical education: Integrated, precise and data‐driven smart solutions

Exploring the Influence of Decisionmaking Style and Financial Status of Cancer Patients on Varied Cultural Aspects of Decision Process

The role of open innovation in addressing resource constraints in healthcare: a systematic literature review

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