RT Journal Article
T1 Interventions to facilitate shared decision-making using decision aids with patients in Primary Health Care
A1 Coronado Vázquez, María del Valle
A1 Canet Fajas, Carlota
A1 Delgado Marroquín, María Teresa
A1 Romero Martín, Macarena
A1 Gómez Salgado, Juan
AB Background: Shared decision making (SDM) is a process within the physician–patient relationship applicable to any clinical action,whether diagnostic, therapeutic, or preventive in nature. It has been defined as a process of mutual respect and participation betweenthe doctor and the patient. The aim of this study is to determine the effectiveness of decision aids (DA) in primary care based onchanges in adherence to treatments, knowledge, and awareness of the disease, conflict with decisions, and patients’ and healthprofessionals’ satisfaction with the intervention.Methods: A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines wasconducted in Medline, CINAHL, Embase, the Cochrane Central Register of Controlled Trials, and the NHS Economic EvaluationDatabase. The inclusion criteria were randomized clinical trials as study design; use of SDM with DA as an intervention; primary careas clinical context; written in English, Spanish, and Portuguese; and published between January 2007 and January 2019. The risk ofbias of the included studies in this review was assessed according to the Cochrane Collaboration’s tool.Results: Twenty four studies were selected out of the 201 references initially identified. With the use of DA, the use of antibiotics wasreduced in cases of acute respiratory infection and decisional conflict was decreased when dealing with the treatment choice for atrialfibrillation and osteoporosis. The rate of determination of prostate-specific antigen (PSA) in the prostate cancer screening decreasedand colorectal cancer screening increased. Both professionals and patients increased their knowledge about depression, type 2diabetes, and the perception of risk of acute myocardial infarction at 10 years without statins and with statins. The satisfaction wasgreater with the use of DA in choosing the treatment for depression, in cardiovascular risk management, in the treatment of low backpain, and in the use of statin therapy in diabetes. Blinding of outcomes assessment was the most common bias.Conclusions: DA used in primary care are effective to reduce decisional conflict and improve knowledge on the disease andtreatment options, awareness of risk, and satisfaction with the decisions made. More studies are needed to assess the impact ofshared decision making in primary care.
PB Lippincott, Williams & Wilkins
SN 1536-5964
YR 2020
FD 2020-08
LK http://hdl.handle.net/10272/18809
UL http://hdl.handle.net/10272/18809
LA eng
NO Coronado Vázquez, V., Canet Fajas, C., Delgado Marroquín, M. T. ... Romero Martín, M. (2020). Interventions to facilitate shared decision-making using decision aids with patients in Primary Health Care. Medicine, 99(32), e21389. DOI: https://doi.org/10.1097/md.0000000000021389
NO This review is part of the research project “Effectiveness of an intervention based on shared decision making for improving the medication of polymedicated chronic patients”, which was awarded the 2016 Esteve Grant for Health Innovation by the Institute of Health Sciences of Aragon.
DS Repositorio Institucional de la Universidad de Huelva
RD 31 may 2026