Shared Decision Making: A Model for Clinical Practice
By G. Elwyn, D. Frosch, R. Thomson, N. Joseph-Williams, Amy Lloyd, P. Kinnersley, Emma Cording, D. Tomson, Carole Dodd, S. Rollnick and 2 more. Journal of general internal medicine, 2012
3,813 citations recorded by the source corpus.
The principles of shared decision making are well documented but there is a lack of guidance about how to accomplish the approach in routine clinical practice. Our aim here is to translate existing conceptual descriptions into a three-step model that is practical, easy to remember, and can act as a guide to skill development. Achieving shared decision making depends on building a good relationship in the clinical encounter so that information is shared and patients are supported to deliberate and express their preferences and views during the decision making process. To accomplish these tasks, we propose a model of how to do shared decision making that is based on choice, option and decision talk. The model has three steps: a) introducing choice, b) describing options, often by integrating the use of patient decision support, and c) helping patients explore preferences and make decisions. This model rests on supporting a process of deliberation, and on understanding that decisions should be influenced by exploring and respecting “what matters most” to patients as individuals, and that this exploration in turn depends on them developing informed preferences.
Subfields: General Health Professions, Psychiatry and Mental health
View Paper: https://www.semanticscholar.org/paper/010654700f3b5c98fd2dba4f97661bd80e7c15b3
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Citations in the corpus
- Erectile Dysfunction: AUA Guideline (2018, background): “with an informed and committed clinician who respects the patient’s competence and capacity to make decisions.(9) To be effective, this process requires”
- 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee (2020, background): “Thus, conditional recommendations are particularly value-and preference-sensitive and always warrant a full shared decision-making approach involving a complete and clear explication of benefits, harms, and burdens in language and in a context that patients understand (16).”
- Computer knows best? The need for value-flexibility in medical AI (2018, positive): “28 29 However, there are two ideas that are fundamental to the concept of shared decision making and particularly relevant in the context of thinking about AI in medicine.”
- Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder (2018, background): “Providers should encourage individuals to actively participate in treatment planning, using a shared decision-making approach (61, 62).”
- “Many miles to go …”: a systematic review of the implementation of patient decision support interventions into routine clinical practice (2013, background): “An alternative model where SDM is initiated by the practitioner in the space of clinical encounters, using briefer DESIs to catalyze dialogue about options, which in turn lead to the use of more extensive tools [44], does not seem to have been extensively investigated, although a few trials exist [4”