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

Researchers interested in shared decision-making in the US have developed a set of tools including decision aids and instruction in counseling, to help patients and physicians fully discuss treatment decisions. Although fundamental research and development continues, these tools are disseminated largely through for-profit and not-for-profit companies to group practices and insurance providers. Data on the number of patients and physicians who have access to decision aids and who have ever used a decision aid are not available, but the number may be small. Policy organisations support the integration of shared decision-making into routine medical care. However, widespread adoption is hindered by lack of evidence for a direct impact on the quality or cost of health care, by limited provider use and lack of patient demand. Future growth requires that people learn about and come to expect that they will discuss treatment options and routinely share making decisions about their care with their care providers--and that their providers welcome and support their patients in doing so.