Will older persons and their clinicians use a shared decision-making instrument?

Area of Science:

• Gerontology
• Health Services Research
• Medical Informatics

Background:

• Shared decision making (SDM) is crucial for patient-centered care, especially for older adults.
• Implementing SDM effectively requires appropriate tools and understanding of user experiences.
• Older adults and clinicians have unique perspectives on healthcare decision-making processes.

Purpose of the Study:

• To explore the experiences of older adults and their clinicians with shared decision making (SDM).
• To assess the willingness of older persons and clinicians to utilize an SDM instrument.
• To identify perceived benefits and barriers to using an SDM instrument in clinical practice.

Main Methods:

• A qualitative focus group study was conducted.
• Involved 41 older adults across 4 focus groups and 11 clinicians across 2 focus groups.
• Data were analyzed using the constant comparative method after transcription and independent coding.

Main Results:

• Patient participants viewed an SDM instrument as a tool to maintain alignment with clinicians and a referenceable part of the medical record.
• Clinician participants saw the instrument as a motivational and educational aid for customizing patient care.
• Both groups expressed potential reluctance due to time constraints and unfamiliarity with participatory goal setting.

Conclusions:

• Older adults and clinicians expressed willingness to adopt an SDM instrument in clinical encounters.
• The instrument was perceived to serve multiple functions, primarily facilitating agreement on treatment goals and plans.
• Findings suggest potential for SDM instruments to enhance patient-clinician collaboration and treatment concordance.