Líf - og heilbrigðisvísindaráðstefna Háskóla Íslands 2021

Is shared decision-making being used in clinical practice?

Main author: Abigail Grover Snook
Institution or Company: University of Iceland/Department of Physiotherapy

Introduction: Shared decision-making is an approach where health care professionals share best available evidence with patients, support patients in considering options, and consider patient preferences when making healthcare decisions. Shared decision-making is considered the “standard of care”, but is it being practiced? This study aimed to investigate healthcare professionals’ attitudes towards the importance of shared decision-making, their actual practice of it, and the differences between importance and practice.

Methods: A sample of physiotherapists (n = 218 – 36% response rate) from the Icelandic Physiotherapist Association who were involved in patient education in clinical practice were surveyed. They rated the importance of and their practice of: (1) asking about patient goals; (2) discussing treatment options; and (3) collaborating with patient to set treatment goals customized to patient needs. Frequencies of importance and practice statements were reported. Differences between importance and practice were determined and tested for significance.

Results: Ninety-seven percent of participants thought asking about patient goals was important but 70% reported asking about them (difference – 27%). Seventy-nine percent thought discussing treatment options was important but 52% reported discussing them (difference – 27%). Eighty-eight percent thought setting customized goals with the patient was important but only 45% reported doing it (difference – 43%). All differences between importance and practice were significant.

Conclusion: Continued efforts need to be focused on teaching healthcare professions what shared decision-making is, providing them with evidence of its effectiveness, and providing practical ways for implementation, with special interest in involving the patient in the decision-making process.


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