Decision Aids That Facilitate Elements of Shared Decision Making in Chronic Illnesses: a Systematic Review

Overview

Journal Syst Rev

Publisher Biomed Central

Date 2019 May 22

PMID 31109357

Citations 32

Authors

Thomas H Wieringa

Rene Rodriguez-Gutierrez

Gabriela Spencer-Bonilla

Maartje de Wit

Oscar J Ponce

Manuel F Sanchez-Herrera

Nataly R Espinoza

Yaara Zisman-Ilani

Marleen Kunneman

Linda J Schoonmade

Victor M Montori

Frank J Snoek

Affiliations

Soon will be listed here.

Abstract

Background: Shared decision making (SDM) is a patient-centered approach in which clinicians and patients work together to find and choose the best course of action for each patient's particular situation. Six SDM key elements can be identified: situation diagnosis, choice awareness, option clarification, discussion of harms and benefits, deliberation of patient preferences, and making the decision. The International Patient Decision Aid Standards (IPDAS) require that a decision aid (DA) support these key elements. Yet, the extent to which DAs support these six key SDM elements and how this relates to their impact remain unknown.

Methods: We searched bibliographic databases (from inception until November 2017), reference lists of included studies, trial registries, and experts for randomized controlled trials of DAs in patients with cardiovascular, or chronic respiratory conditions or diabetes. Reviewers worked in duplicate and independently selected studies for inclusion, extracted trial, and DA characteristics, and evaluated the quality of each trial.

Results: DAs most commonly clarified options (20 of 20; 100%) and discussed their harms and benefits (18 of 20; 90%; unclear in two DAs); all six elements were clearly supported in 4 DAs (20%). We found no association between the presence of these elements and SDM outcomes.

Conclusions: DAs for selected chronic conditions are mostly designed to transfer information about options and their harms and benefits. The extent to which their support of SDM key elements relates to their impact on SDM outcomes could not be ascertained.

Systematic Review Registration: PROSPERO registration number: CRD42016050320 .

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