Our research identifies key barriers to shared decision making.
Shared decision making (SDM) empowers individuals to make decisions about their treatment options with the support of their clinician. It is a collaborative process which utilises the clinician's expertise, but acknowledges the preferences, values and circumstances of the patient. It is widely accepted and evidenced as the gold standard approach to making healthcare decisions. However, routine implementation in practice has been slow.
Our researchers have led a major research programme to identify the barriers to routine SDM implementation. As a result of their findings, various tools were developed to help embed this approach in routine healthcare settings.
These tools included a new ‘three-talk’ SDM model, healthcare professional skills training, and improved patient decision aids for use in clinical consultations, all of which are key to helping people make informed and value-based choices about healthcare that take their personal preferences into consideration.
Making Good Decisions in Collaboration (MAGIC)
The research project, a joint research programme between Cardiff University and Newcastle universities, was titled the Making Good Decisions in Collaboration (MAGIC) Programme. Key barriers to SDM implementation in various routine clinical settings were identified, and different forms of training and patient decision aids developed.
Our own research focused on developing a new SDM model for clinical practice. Concurrently, Newcastle University explored alternative ways to support SDM engagement and measurement within organisations.
The MAGIC programme research found that clinicians:
- believed that they already involved patients in decisions about their care
- often reported that patients did not want SDM
- lacked the right tools to implement SDM
- did not have time to focus on SDM due to other demands on time
The team also found that:
- patients often felt unable to participate in SDM due to lack of knowledge, or due to the perceived power imbalance in the clinician-patient relationship
- providing patients with decision aids during the consultation led to greater engagement than tools provided after consultations (such as information leaflets and website links)
- it was challenging to capture the difference that SDM made to patients
The identification of these areas kick-started the Cardiff University team to focus on how SDM implementation could be more successful.