Training health professionals in shared decision-making: An international environmental scan

Diouf, Ndeye Thiab; Menear, Matthew; Robitaille, Hubert; Guérard, Geneviève Painchaud

doi:10.1016/j.pec.2012.01.002

Cited by 199 publications

(135 citation statements)

References 60 publications

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“…[22][23][24] In the context of acute respiratory infections, this appears to reduce the use of a treatment option (i.e., antibiotics) not clearly associated with benefits for all patients.…”

Section: Discussionmentioning

confidence: 99%

“…• Out of 213 patients, 178 eligible patients consulted 72 physicians; median practice size = 16 physicians, range [14][15][16][17][18][19][20][21][22][23][24][25][26] Units included in the intervention group n = 5 teaching units. We excluded physicians who had participated in the DECISION+ pilot trial 13 or who did not expect to practise in the teaching unit during the trial period.…”

Section: Participantsmentioning

confidence: 99%

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Training family physicians in shared decision-making to reduce the overuse of antibiotics in acute respiratory infections: a cluster randomized trial

Légaré

Labrecque

Cauchon

et al. 2012

CMAJ

Self Cite

181

189

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D espite recent efforts to decrease the use of antibiotics for acute respiratory infections, their prescription is still too frequent 1,2 and may be contributing to antibiotic resistance. 1 Only 6%-18% of children with acute respiratory infections, 5%-15% of adults with pharyngitis and 38% of adults with acute rhinosinusitis have bacterial infections. 3,4 Studies investigating improvement in clinical decision-making about the use of antibiotics for acute respiratory infections have been inconclusive, and interventions to reduce their use have shown only moderate success. 5 In the shared decision-making model, a health care professional and the patient make a decision together based on the best available evidence and the patient's values and preferences. 6 Shared decision-making is recognized as an effective strategy for reducing the overuse of treatment options not clearly associated with benefits for all patients. 7 In a randomized pilot trial, we showed that an earlier version of the training program in shared decision-making (DECISION+) reduced the proportion of patients who decided to use antibiotics immediately after consulting for acute respiratory infections (control 49%, DECISION+ 33%; absolute difference 16%; p = 0.08), a reduction that was maintained 6 months later. 8 However, because only 46% of enrolled providers in the pilot trial participated in all three 3-hour workshops, we improved the training program before conducting a definitive trial. 9 Following an in-depth evaluation with participants in the pilot trial, 10,11 we modified the training program and renamed it DECISION+2. In the current study, we evaluated its effect on the proportion of patients who decided to use antibiotics for acute respiratory infections after physician consultation. Background: Few interventions have proven effective in reducing the overuse of antibiotics for acute respiratory infections. We evaluated the effect of DECISION+2, a shared decision-making training program, on the percentage of patients who decided to take antibiotics after consultation with a physician or resident.

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Section: Discussionmentioning

confidence: 99%

Section: Participantsmentioning

confidence: 99%

Training family physicians in shared decision-making to reduce the overuse of antibiotics in acute respiratory infections: a cluster randomized trial

Légaré

Labrecque

Cauchon

et al. 2012

CMAJ

Self Cite

181

189

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“…33 Measuring process and outcomes: where we aim to and how we get there One author in this special issue has highlighted the role of monitoring children's rights as a means of advancing accountability and measuring progress 34 yet much work remains to be made in this realm. 35 Monitoring and evaluation of systems and services are required to assess the process and outcomes of children and young people's participation in relation to protection efforts in diverse contexts and amongst various subgroups of children and young people, including any unintended negative consequences that may ensue. Longitudinal designs are needed to explore the long-term impact of participation on children, young people and communities.…”

Section: Children's Rights and Social Implementation In Contextmentioning

confidence: 99%

Children’s rights to participation and protection in international development and humanitarian interventions: nurturing a dialogue

Ruiz‐Casares

Collins

Tisdall

et al. 2016

The International Journal of Human Rights

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This introduction provides the rationale for the special issue of the International Journal of Human Rights on the topic of the children's right to participation and protection in international development and humanitarian efforts. It summarises selected contributions relating to an international conference entitled 'Facilitating Child Participation in International Child Protection' that took place 5-6 October 2015 at Ryerson University in Toronto (Canada). The concepts of child participation and child protection are explored. Then, the challenges and opportunities are highlighted regarding the actual and potential participatory role of children and young people in effective child protection. Finally, an overview of the articles included in this collection is provided.

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“…Second, our research has shown that both doctors in training and practising doctors can be taught to share decisions with their patients [57]. The number of training programs in SDM is increasing exponentially worldwide [58], but they are so heterogeneous that it is still hard to say what kind of training works best and, at the minimum, what an effective program needs to include. However, a recent Cochrane review suggests that any training is better than none, and that programs targeting both patients and physicians are more promising than those targeting one or the other.…”

Section: Following Through With the Decisionmentioning

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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Training health professionals in shared decision-making: An international environmental scan

Cited by 199 publications

References 60 publications

Training family physicians in shared decision-making to reduce the overuse of antibiotics in acute respiratory infections: a cluster randomized trial

Training family physicians in shared decision-making to reduce the overuse of antibiotics in acute respiratory infections: a cluster randomized trial

Children’s rights to participation and protection in international development and humanitarian interventions: nurturing a dialogue

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

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