Shared decision making and its role in managing uncertainty and reducing low-value care

Area of Science:

• Healthcare Management
• Patient-Centered Care
• Clinical Communication

Background:

• Shared decision making (SDM) offers significant advantages for patients, healthcare providers, and the overall healthcare system.
• Patient involvement in healthcare decisions is recognized as a fundamental right.

Purpose of the Study:

• To investigate the optimal timing and methods for implementing SDM within clinical consultations.
• To raise awareness regarding the utility of simple tools in supporting SDM, especially in scenarios involving medical uncertainty and low-value care choices.

Main Methods:

• Exploratory analysis of SDM implementation in primary care settings.
• Review of existing tools and strategies to support SDM.
• Focus on communication techniques within consultations.

Main Results:

• SDM can be integrated into primary care consultations without necessarily requiring specialized tools, though many can be beneficial.
• Available tools do not appear to extend consultation times.
• Key steps include encouraging patient questions, discussing benefits/harms of all options (including watchful waiting), and eliciting patient values.

Conclusions:

• SDM is a vital component of patient-centered primary care.
• Effective SDM relies on open communication, exploring patient preferences, and discussing treatment options thoroughly.
• Simple communication strategies can facilitate SDM, even without complex tools.