Editorial

Implementing Shared Decision Making in Diverse Health Care Systems: the Role of Patient Decision Aids

Aims of patient decisions aids

PtDAs are standardized, evidence-based tools intended to facilitate the process of arriving at an informed, values-based choice among two or more health care alternatives (which may include ‘watchful waiting’). They are designed to supplement rather than replace patient-practitioner interaction. PtDAs help patients to personalize information on options and outcomes, understand that they can participate in decision making, appreciate the scientific uncertainties inherent in that choice, clarify

Barriers and successful strategies

Several barriers to implementing PtDAs have been identified in the U.S. and Canadian health systems [5], [6]. Although physicians feel positively toward PtDAs, there are organizational’ barriers. To enhance use of PtDAs, Holmes-Rovner and colleagues [6] reported the following strategies suggested by physicians: integration in the consent process, creating a quality care indicator for their routine use, providing direct patient access, and offering financial incentives to practitioners for their

Conclusion

There is a need for large scale implementation projects with diverse populations, such as ones currently taking place in the UK and North America. The effects of integrating PtDAs into the process of care needs to be evaluated on criteria such as decision quality, unwarranted practice variation, and cost. The ‘appropriate’ rates of surgery need to be re-defined not only on the basis of clinical need but also informed patient preferences. Guarantees regarding waiting list times need to be

This issue

This issue of Patient Education and Counseling is a welcome to the participants of the 3rd International Shared Decision Making Conference. A few articles cover the theme of the conference: women's misconceptions about cancer screening (implications for informed decision making), decision evaluation scales, risk estimates and changing the feeling of risk in breast cancer patients, and physician use of a participatory decision-making style with children with ADHD.

Other articles in this issue