Shared decision making: examining key elements and barriers to adoption into routine clinical practice
Abstract
For many patients, the time spent meeting with their physician-the clinical encounter-is the most opportune moment for them to become engaged in their own health through the process of shared decision making. In the United States shared decision making is being promoted for its potential to improve the health of populations and individual patients, while also helping control care costs. In this overview we describe the three essential elements of shared decision making: recognizing and acknowledging that a decision is required; knowing and understanding the best available evidence; and incorporating the patient's values and preferences into the decision. To achieve the promise of shared decision making, more physicians need training in the approach, and more practices need to be reorganized around the principles of patient engagement. Additional research is also needed to identify the interventions that are most effective.
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Empirical evidence contributing to individualized treatment regimens based on tailoring variables, treatment history, and current response status will have the added advantage of supporting shared decision-making by the child and parents with an empirically-informed clinician.
“Empirical evidence contributing to individualized treatment regimens based on tailoring variables, treatment history, and current response status will have the added advantage of supporting shared decision-making by the child and parents with an empirically-informed clinician [65, 66]”
From A Sequential Multiple Assignment Randomized Trial (SMART) study of medication and CBT sequencing in the treatment of pediatric anxiety disorders (2021) · cites this paper as [66]
HCPs often cite limited time as a barrier to shared decision making.
“However, HCPs often cite limited time as a barrier to this process,[38–39]”
From Perceived healthcare provider reactions to patient and caregiver use of online health communities (2014) · cites this paper as [38]
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- Authors
- Légaré, F., & Witteman, H. O.
- Affiliations
- Université Laval (CA)
- Venue
- Health Affairs
- Publisher
- Health Affairs Publishing, LLC
- Published
- 2013-02
- Volume
- 32
- Issue
- 2
- Pages
- 276-284
- ISSN
- 0278-2715 (ISSN-L)
- 1544-5208
- OpenAlex
- W2013667564
- Cited by
- 783
- References
- 36
- Citations by year
- 2026: 38 · 2025: 59 · 2024: 53 · 2023: 62 · 2022: 75 · 2021: 71 · 2020: 86 · 2019: 64 · 2018: 63 · 2017: 62 · 2016: 45 · 2015: 44 · 2014: 39 · 2013: 21 · 2012: 1
- FWCI
- 5.96
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Health Affairs (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Keywords
- shared decision-making, patient engagement, clinical adoption, implementation barriers, physician training, patient values and preferences, evidence-based medicine, patient-centered care, health care costs
- MeSH terms
- Cost Control, Decision Making, Delivery of Health Care, Education, Medical, Continuing, Health Policy, Humans, Patient Participation, Physician-Patient Relations, Evidence-Based Medicine, Patient Preference
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