Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2015 Oct 2;112(40):665-71.
doi: 10.3238/arztebl.2015.0665.

Outcome-Relevant Effects of Shared Decision Making

Katarina Hauser  1 , Armin Koerfer, Kathrin Kuhr, Christian Albus, Stefan Herzig, Jan Matthes
Affiliations
Review

Outcome-Relevant Effects of Shared Decision Making

Katarina Hauser et al. Dtsch Arztebl Int. .

Abstract

Background: Shared decision making (SDM) is considered a gold standard for the cooperation of doctor and patient. SDM improves patients' overall satisfaction and their confidence in decisions that have been taken. The extent to which it might also positively affect patient-relevant, disease-related endpoints is a matter of debate.

Methods: We systematically searched the PubMed database and the Cochrane Library for publications on controlled intervention studies of SDM. The quality of the intervention and the risk of bias in each publication were assessed on the basis of pre-defined inclusion and exclusion criteria. The effects of SDM on patient-relevant, disease-related endpoints were compared, and effect sizes were calculated.

Results: We identified 22 trials that differed widely regarding the patient populations studied, the types of intervention performed, and the mode of implementation of SDM. In ten articles, 57% of the endpoints that were considered relevant were significantly improved by the SDM intervention compared to the control group. The median effect size (Cohen's d) was 0.53 (0.14-1.49). In 12 trials, outcomes did not differ between the two groups. In all 22 studies identified, 39% of the relevant outcomes were significantly improved compared with the control groups.

Conclusion: The trials performed to date to addressing the effect of SDM on patient-relevant, disease-related endpoints are insufficient in both quantity and quality. Although just under half of the trials reviewed here indicated a positive effect, no final conclusion can be drawn. A consensus-based standardization of both SDM-promoting measures and appropriate clinical studies are needed.

PubMed Disclaimer

Figures

eFigure
eFigure
Systematic selection process of outcomes studies on shared decision making SDM, shared decision making
See this image and copyright information in PMC

Comment in

  • Shortcomings in Education and Training.
    Hein G. Hein G. Dtsch Arztebl Int. 2016 Apr 29;113(17):299. doi: 10.3238/arztebl.2016.0299a. Dtsch Arztebl Int. 2016. PMID: 27173410 Free PMC article. No abstract available.
  • Consensus About Objectives.
    Scheibler FL. Scheibler FL. Dtsch Arztebl Int. 2016 Apr 29;113(17):299. doi: 10.3238/arztebl.2016.0299b. Dtsch Arztebl Int. 2016. PMID: 27173411 Free PMC article. No abstract available.

References

    1. Laidsaar-Powell RC, Bu S, McCaffery KJ. Partnering with and involving patients. In: Martin LR, DiMatteo RM, editors. The Oxford handbook of health communication, behavior change, and treatment adherence. New York: Oxford University Press; 2014. pp. 84–108.
    1. Perk J, De Backer G, Gohlke H, et al. European guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts) Eur Heart J. 2012;33:1635–1701. - PubMed
    1. Loh A SD, Kriston L, Härter M. Shared decision making in medicine. Dtsch Arztebl. 2007;104:A 1483–A1488.
    1. Joosten EA, DeFuentes-Merillas L, de Weert GH, Sensky T, van der Staak CP, de Jong CA. Systematic review of the effects of shared decision-making on patient satisfaction, treatment adherence and health status. Psychother Psychosom. 2008;77:219–226. - PubMed
    1. Matthes J, Albus C. Improving adherence with medication: a selective literature review based on the example of hypertension treatment. Dtsch Arztebl Int. 2014;111:41–47. - PMC - PubMed

MeSH terms