What Influences the Implementation of Shared Decision Making: An Umbrella Review |
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| Institution: | 1. Public Health, The University of Sheffield, Sheffield, UK;2. Health Economics and Decision Science, The University of Sheffield, Sheffield, UK;3. Centre for Assistive Technology and Connected Healthcare, The University of Sheffield, Sheffield, UK;4. College of Business, University of Jeddah, Jeddah, Saudi Arabia;5. Biomedical Technology Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia;1. Department of Family Practice, School for Public Health and Primary Care CAPHRI Maastricht University, Maastricht, NL;2. Dutch Federation of Patient Organisations, Utrecht, NL;3. Isala Women''s and Children''s Hospital, Zwolle, and UMCG Postgraduate School of Medicine, University Medical Centre and University of Groningen, Groningen, NL;4. Trant voor de zorg van morgen, zelfstandig adviesbureau., Wijk bij Duurstede, NL;5. Dutch College of General Practitioners, Utrecht, Utrecht, NL;6. Program manager health care innovation, CZ Health Care Insurance, Tilburg, NL;7. Health Evidence, Radboud University Medical Centre, Nijmegen, NL;8. Department of Public and Occupational Health and Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, NL;9. Department of Medical Decision Making, Leiden University Medical Centre, Leiden, NL;1. Department of Rheumatology, Sint Maartenskliniek, Nijmegen, the Netherlands;2. Department of Pharmacy, Sint Maartenskliniek, Nijmegen, the Netherlands;3. Department of Pharmacy, Radboud University Medical Center, Nijmegen, the Netherlands;4. Department of Rheumatology, Radboud University Medical Center, Nijmegen, the Netherlands;1. Allergy, Asthma, and Sinus Center, Greenfield, Wisconsin;2. The Problem Based Learning Institute, Chesterfield, Missouri;3. AltusLearn, Madison, Wisconsin;4. SDM Analytics, Inc, Houston, Texas;1. Department of Quality and Safety, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, the Netherlands;2. Oncology Centre, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, the Netherlands;3. Maastricht University Medical Centre, Department of Radiotherapy (MAASTRO Clinic), GROW School for Oncology and Developmental Biology, Dr. Tanslaan 12, 6229 ET, Maastricht, the Netherlands;4. School CAPHRI, Care and Public Health Research Institute, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, the Netherlands;5. Faculty of Health, Medicine and Life Sciences, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, the Netherlands;6. Department of Family Medicine, Maastricht University, Debeyeplein 1, 6229 ER, Maastricht, the Netherlands;1. Cardiff University, College of Biomedical and Life Sciences, School of Medicine, Division of Population Medicine, Cardiff, UK;2. Cardiff University, College of Biomedical and Life Sciences, Centre for Trials Research, Cardiff, UK;3. Pre dialysis Team, Cardiff and Vale University Health Board, Nephrology and Transplant Directorate, University Hospital of Wales, Cardiff, UK;4. Cardiff Breast Centre, Cardiff and Vale University Health Board, University Hospital Llandough, Cardiff, UK |
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| Abstract: | ObjectiveTo provide a cogent summation of the evidence base of the key barriers and facilitators to implementing shared decision making (SDM).MethodsAn umbrella review of existing reviews on SDM was adopted. Databases were searched from 1997 to December 2018. Studies were included if they performed a review of barriers and facilitators to SDM. Results: 7 eligible reviews were identified. The five themes identified were: patient factors, professional factors, environmental factors, relationship factors, and factors related to information provision. Lack of time was the main factor hindering the implementation of SDM. Encouragement and motivation of providers to use SDM was a significant enabler of SDM implementation.ConclusionsThe provision of time and resources are insufficient if not accompanied by efforts to support and motivate providers to use SDM.Practice implicationsHealthcare providers need to be educated on the importance of building a relationship with their patients. To enhance this relationship, physicians may need to improve their interaction skills. They need to be curious and explore their patients' preferences, listen to them and respect their opinions, explain options and outcomes, and encourage them to participate in the decision making. |
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| Keywords: | Shared decision making umbrella review patient-centred care barriers/facilitators implementation |
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