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Shared decision-making in advanced kidney disease: a scoping review
Noel Engels1,2,3, Gretchen N de Graav3, Paul van der Nat4
1Department of Shared Decision-Making and Value-Based Health Care, Santeon, Utrecht, The Netherlands n.engels@santeon.nl.
BMJ Open
|September 21, 2022
Summary
This scoping review found 145 interventions to support shared decision-making (SDM) in advanced kidney disease (AKD), but no single intervention is proven most effective. More research is needed to understand their impact on patient outcomes.
Area of Science:
- Nephrology
- Health Services Research
- Patient-Centered Care
Background:
- Shared decision-making (SDM) is crucial for treatment modality choices in advanced kidney disease (AKD).
- A comprehensive overview of existing and developing SDM interventions in AKD is lacking.
Purpose of the Study:
- To systematically review interventions supporting SDM for treatment decisions in AKD.
- To summarize intervention content, use, and reported outcomes.
- To identify interventions currently under development.
Main Methods:
- A scoping review following JBI methodology and PRISMA-ScR guidelines.
- Searched multiple databases for peer-reviewed and grey literature.
- Extracted data on intervention type, decision support, and reported effects.
Main Results:
- 145 interventions identified: 52 prognostic tools, 51 educational programs, 29 patient decision aids, 13 multicomponent initiatives.
- 11% were novel, 35.7% implemented in practice, 51.9% evaluated for outcomes.
- Significant variation in outcome measures and limited reporting on SDM effects.
Conclusions:
- No definitive evidence identifies the most efficacious intervention for SDM in AKD.
- The evidence base is primarily observational with under-reported effects on SDM.
- Further research is needed to establish intervention efficacy and standardize outcome reporting.
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