HEALTH-SYSTEM. ADMINISTRATOR. I'm convinced that shared decision making leads to better health outcomes and helps patien
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PATIENT-CENTERED OUTCOMES RESEARCH INSTITUTE
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RESEARCH SPOTLIGHT ON
Shared Decision Making Most people want to be involved in decisions about their health care. But patients, their families, and their healthcare providers don’t always know whether, when, or how to most effectively discuss topics such as the possible trade-offs of their care options and patients’ personal preferences. Increasingly, shared decision making is addressing these concerns. In shared decision making, a clinician provides a patient with information about diagnostic or treatment options, including potential benefits and harms, in a form the patient finds easy to understand. The patient is prompted to explain his or her preferences about the potential outcomes of those options, any concerns, and other issues of importance to him or her. The clinician and patient then discuss which care plan makes the most sense given the patient’s preferences. Research has found that shared decision making can increase patients’ satisfaction, improve their health outcomes, and lead to lower demand for healthcare resources.
Research Addressing Questions That Matter PCORI was established to support studies comparing healthcare options and to produce evidence that will help patients and those who care for them make better-informed decisions. As part of that charge, we fund research comparing ways to improve communication about care options and evaluating approaches to shared decision making. We also fund projects comparing ways to disseminate promising study results and promote their implementation in clinical practice.
Questions That Research May Address PATIENT I’ve had lower back pain for more than a year. I don’t like taking painkillers every day, but I worry that surgery would keep me out of work for a long time. How can I let my doctor know what’s important to me, so we can reach the treatment decision that works best for me?
CLINICIAN Some of my patients don’t take the medications I prescribe. How can I most effectively understand what keeps them from doing so and how can I talk to them about a treatment plan that they will be likely to follow?
HEALTH-SYSTEM ADMINISTRATOR I’m convinced that shared decision making leads to better health outcomes and helps patients follow their medication plans. How can I make it easy for our clinicians to take that approach?
Getting People the Information They Need Decision aids are tools that provide information about available treatment options, help patients clarify their values and preferences, and encourage patients, their families, and clinicians to communicate effectively. Past research has shown that patients who use decision aids are better informed about their options, have more-accurate perceptions of risk, make decisions that are better aligned with their goals and preferences, and are more comfortable with their decisions. PCORI is funding several studies comparing such tools and how to use them most effectively.
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As of September 2017, PCORI has awarded
$330 MILLION TO FUND 124
comparative clinical effectiveness research studies related to shared decision making and decision tools.
STUDY SPOTLIGHT
STUDY SPOTLIGHT
Shared Decision Making in the Emergency Department
Promoting Informed Decisions about Lung Cancer Screening
Although chest pain sends many people to emergency departments, a significant percentage are not having a heart attack or other serious heart problems. Using a questionnaire called Chest Pain Choice proved effective in helping such individuals decide whether to forgo unnecessary hospital stays and intensive medical tests. People who used the questionnaire were more knowledgeable about their risk and care options and more involved in their care decisions than people who didn’t use it. Results appear in The BMJ. Further details are at www.pcori.org/Hess030.
A video-based decision aid titled “Lung Cancer Screening: Is It For Me?” is designed to facilitate shared decision making by helping patients understand the risks and benefits of annual screening for lung cancer using low-dose computed tomography. The study is comparing the experiences and decisions made by individuals who used the video to those of people who received standard educational materials about screening. For more information, visit www.pcori.org/Volk029.
BY THE NUMBERS
By number of projects
All Decision-Making Studies
Decision-Tool Studies
Shared Decision Making Studies
Most Studied Conditions 38 31
Cancer 18
27
Mental/ Behavioral Health
Neurological Disorders
Cardiovascular Diseases
18 15
19 11 11 18 15 9
Multiple/ Comorbid Chronic Conditions Respiratory Diseases
17 14 5 14 11 6
Most Studied Populations of Interest 89
Racial/Ethnic Minorities
Low Socioeconomic Status
72
44 40
Older Adults
43
39
21
32
Women
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UPDATED SEPTEMBER 2017
32 28
Rural
23
23
LEARN MORE AT HTTPS://WWW.PCORI.ORG/SDMSPOTLIGHT
15 41
57 47
32
Urban
13
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RESEARCH DONE DIFFERENTLY®
