Empowering Patients Through Shared Decision-Making

 

Learn how patient decision aids and shared decision-making can improve patient care by empowering patients to make informed choices aligned with their values.

Making important health decisions can be challenging for patients. Often, there are multiple reasonable options, each with different benefits and downsides.

Patients may struggle to understand their options fully or determine which empowering patients to make informed decisions aligns best with their preferences and values.

This can lead to decision regret, anxiety, and poor health outcomes. Patient decision aids and shared decision-making aim to empower patients to make high-quality choices by providing information and guidance tailored to their specific situation.

Patient Decision Aids Help Patients Understand Their Options

Patient decision aids are evidence-based tools designed to inform patients about available options and help them clarify their personal values related to the decision. They provide details about:

• The benefits and risks of each option
• What it's like to experience the consequences of each option
• How the options align with what matters most to the patient

Some examples of patient decisions where these aids can help include:

• Whether to undergo knee replacement surgery for osteoarthritis or try more conservative treatments first
• Choosing between lumpectomy or mastectomy for early-stage breast cancer
• Deciding about medications and screening options for conditions like diabetes, heart disease, and depression

Research shows that patient decision aids lead to improved knowledge, more accurate risk perceptions, and greater confidence in decisions compared to usual care.

A 2014 Cochrane review found exposure to decision aids reduced decisional conflict, increased patients' participation in the decision-making process, and improved patient-clinician communication.

Shared Decision Making Fosters Collaboration Between Patients and Clinicians

Using patient decision aids is often part of a shared decision-making process. With shared decision-making:

• The clinician explains the condition and options to the patient while acknowledging that the best choice depends on the patient's values and preferences.
• The patient shares their preferences, concerns, and desired role in choosing a treatment plan.
• Together, they discuss the benefits, harms, and consequences of each option to determine the best course forward.

This collaborative process leads to decisions that align with evidence and the patient's values.

A 2018 study published in JAMA Internal Medicine found that shared decision-making increased patient knowledge and satisfaction while reducing decision regret and provider malpractice claims.

Shared decision-making is especially important for preference-sensitive decisions where more than one reasonable path exists.

A 2020 systematic review reported that patients who participated in shared decision-making were more likely to improve their risk perceptions, choose more conservative treatment options, and feel empowered in their care.

Better Decision-Making Leads to Improved Patient Satisfaction and Outcomes

Empowering patients through tools like decision aids and shared decision-making offers many benefits:

• Patients gain a nuanced understanding of their condition and options
• Anxiety, decision regret, and uncertainty are reduced
• Values-aligned choices lead to better health outcomes and satisfaction
• Patients feel respected, heard, and engaged as partners in their care

In a 2013 Health Affairs study, 85% of patients indicated they would want decision aids for 10 common preference-sensitive conditions, suggesting high acceptability of this approach.

Additionally, a 2020 meta-analysis published in The BMJ determined that patient decision aids used within the shared decision-making process can help avoid unwarranted procedures, leading to over $9 billion in savings annually for the U.S. healthcare system.