|Health Factors:||Quality of Care|
|Decision Makers:||Healthcare Professionals & Advocates|
|Population Reach:||50-99% of WI's population|
|Impact on Disparities:|
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Under a shared decision making (SDM) process, health care practitioners and patients work together to make joint decisions about a patient’s care. SDM requires that patients be educated about and understand risks and benefits of their options (Cochrane-Legare 2010). SDM is an important part of patient-centered care; education is often through the use of decision aids such as pamphlets, videos, and computerized tools.
There is strong evidence that patient shared decision making (SDM) using decision aids improves patients’ knowledge of treatment options and increases their involvement in the decision making process (Cochrane-Stacey 2014, OBrien 2009). Patient SDM using decision aids may also improve health outcomes (Cochrane-Legare 2010).
Decision aids increase patients’ knowledge about their treatment options (Cochrane-Stacey 2014, OBrien 2009) and can reduce anxiety related to treatment (Dugas 2012, Joosten 2008, OBrien 2009). Using probabilities in those aids, especially expressed in numbers, improves the accuracy of the level of risk patients perceive (Cochrane-Stacey 2014). Computerized aids appear as effective as aids delivered in person (Sheehan 2012).
Decision aids improve patient participation in their treatment decisions (Cochrane-Stacey 2014) and help patients make difficult decisions (Cochrane-Stacey 2014, OBrien 2009). SDM has been shown to be particularly effective for patients making long-term decisions and patients with chronic health problems (Joosten 2008). Use of decision aids has been shown to reduce the frequency of major elective surgeries, PSA screening, and the choice to use menopausal hormones (Cochrane-Stacey 2014). SDM can also support women’s decision making related to pregnancy and birth (Dugas 2012). Educational meetings, feedback, learning materials, and decision aids may help health care providers adopt SDM (Cochrane-Legare 2010).
The impact of patient shared decision making on health care costs is unclear. Some studies show no savings, though no additional costs, while others suggest per person savings ranging from $8 to $3,068 (Walsh 2014).
The Informed Medical Decisions Foundation supports 10 shared decision making demonstration sites across the country. It also has developed a variety of decision aid programs, focusing on topics such as breast cancer, cardiovascular disease, screening and testing programs, and mental health (IMDF).
Individual health care systems may implement SDM, however, there is no SDM legislation in Wisconsin (IMDF).
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