Shared Decision Making in Telehealth Versus In-Person Pediatric Primary Care

Area of Science:

• Pediatric Healthcare
• Health Communication
• Digital Health

Background:

• The rapid expansion of telehealth in pediatrics necessitates an evaluation of its impact on patient-clinician communication.
• Specifically, the effect on shared decision making (SDM) remains under-examined.

Purpose of the Study:

• To compare the quality of shared decision making (SDM) in pediatric primary care between telehealth and in-person visits.
• To assess how communication effectiveness, measured by the Informed Decisions Measure (IDM), differs across these modalities.

Main Methods:

• Recorded 88 pediatric primary care visits (46 telehealth, 42 in-person).
• Scored communication quality using an adapted Informed Decisions Measure (IDM).
• Analyzed differences in IDM scores between telehealth and in-person visits using mixed-effects models.

Main Results:

• No statistically significant difference was found in parent IDM scores between telehealth (5.43 ± 3.34) and in-person (5.19 ± 3.39) visits.
• Adolescent IDM scores also showed no significant difference between telehealth (4.00 ± 3.26) and in-person (5.43 ± 3.8) visits.
• Overall, SDM quality was comparable across both care delivery methods.

Conclusions:

• Telehealth in pediatric primary care demonstrates equivalent quality of shared decision making (SDM) compared to traditional in-person visits.
• This parity presents an opportunity to create unified training programs for clinicians that enhance SDM in both telehealth and in-person settings.
• Future research should focus on developing and implementing such adaptable training strategies.