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Shared decision-making in the US--research & development outpaces delivery.

Margaret Holmes-Rovner1, Jessie Gruman, David R Rovner

  • 1Health Services Research, Michigan State University, 2007 Visiting Professor, Center for the Advancement of Health, Washington DC, USA. mholmes@msu.edu

Zeitschrift Fur Arztliche Fortbildung Und Qualitatssicherung
|July 3, 2007
PubMed
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Shared decision-making tools aid patient-physician discussions. Widespread adoption of these shared decision-making aids is limited by a lack of evidence on healthcare impact and low demand.

Area of Science:

  • Health Services Research
  • Medical Decision Making
  • Patient Engagement

Background:

  • Shared decision-making (SDM) involves patients and physicians discussing treatment options.
  • Tools like decision aids and counseling have been developed to support SDM in the US.
  • Dissemination of these tools occurs through commercial and non-profit entities to healthcare providers.

Purpose of the Study:

  • To examine the development and dissemination of shared decision-making tools.
  • To identify barriers to the widespread adoption of SDM in routine medical care.
  • To explore factors necessary for the future growth of SDM.

Main Methods:

  • The study synthesized information on the development and distribution of SDM tools.
  • It reviewed policy support for SDM integration into healthcare.

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  • It analyzed factors hindering and promoting SDM adoption.

    • Main Results:

    • While SDM tools exist, data on patient and physician access and usage are limited, suggesting potentially low numbers.
    • Policy organizations advocate for SDM, but its integration faces challenges.
    • Key barriers include a lack of evidence demonstrating direct impact on healthcare quality or cost, limited provider utilization, and insufficient patient demand.

    Conclusions:

    • Widespread adoption of shared decision-making is currently hindered by a lack of proven impact on healthcare quality and cost, alongside limited provider use and patient demand.
    • Future growth of SDM necessitates increased awareness and expectation among patients and providers for collaborative treatment decision-making.
    • Healthcare providers must actively support and welcome patient participation in shared decision-making processes.