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Can the current hypodontia care pathway promote shared decision-making?

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The current hypodontia care pathway offers limited support for shared decision-making (SDM) between patients and clinicians. Improvements are needed to enhance patient engagement and incorporate individual preferences into treatment planning for better outcomes.

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Area of Science:

  • Dentistry
  • Healthcare Management
  • Patient-Centered Care

Background:

  • Hypodontia, the congenital absence of teeth, requires complex management involving interdisciplinary teams.
  • Shared decision-making (SDM) is crucial for patient-centered care, ensuring treatment aligns with individual values and preferences.
  • The effectiveness of current hypodontia care pathways in promoting SDM remains unclear.

Purpose of the Study:

  • To evaluate the extent to which the existing care pathway for hypodontia facilitates shared decision-making (SDM).
  • To identify barriers and facilitators to SDM within hypodontia treatment consultations.

Main Methods:

  • An exploratory, qualitative, cross-sectional study was conducted in two NHS teaching hospitals.
  • Data were collected through observation of interdisciplinary consultations (n=5) and semi-structured interviews with young patients (n=8) and their parents (n=8).
  • Thematic framework analysis was applied to transcribed audio-recordings of consultations and interviews.

Main Results:

  • Consultations demonstrated good communication and information provision but showed low patient engagement.
  • Time constraints limited thorough information exchange and assessment of patient understanding.
  • Parents expected the dental team to make decisions, while young patients relied on parental advocacy, indicating a lack of SDM despite reported treatment satisfaction.

Conclusions:

  • The current hypodontia care pathway inadequately supports clinicians in implementing SDM.
  • Recommendations include enhancing patient information access, utilizing preference elicitation tools, and developing strategies for effective communication of complex information to support value-driven decision-making.