What is the evidence?
Cochrane reviews and updates in 2011 and 2014, 2017
- 105 RCTs of decision aids or interventions
- Review of interventions to engage health care providers
- Exponential rise in shared decision making hits in the literature in last 5 years
- Guidelines
Cochrane reviews and updates in 2011 and 2014, 2017
For patients
- Increased knowledge
- More accurate risk perceptions
- Greater number of decisions consistent with patients’ values
- Reduced level of decisional conflict for patients
- Fewer patients remaining undecided
For health care practitioners
- Better patient –practitioner communication
- Not time consuming
- No harms
For the health system
- More cost effective
- May improve over diagnosis and over treatment
- Many patients actually chose less invasive and less costly actions
- Appears to reduce practice variations
- Can alleviate differences in decision making for low SES
What is the evidence in Paediatrics?
Children should be involved in decision making to the fullest extent possible (UNCRC, AAP)
Decision coaching improved parent child congruence and child satisfaction with decision making (Lyon 2009)
