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患者与医疗服务提供者对共同决策的看法:同行评审文献的系统综述

Patient and provider perspectives on shared decision making: a systematic review of the peer-reviewed literature.

作者信息

Williams Nyna, Fleming Chris, Doubleday Annie

机构信息

Mathematica Policy Research, 1100 First Street, NE, 12th Floor, Washington, DC 20002, USA.

出版信息

J Comp Eff Res. 2017 Nov;6(8):683-692. doi: 10.2217/cer-2017-0045. Epub 2017 Nov 17.

Abstract

For comparative effectiveness research to be effective, patients and providers must collaborate in shared decision making (SDM) to make evidence-based clinical decisions that align with patient preferences. We conducted a systematic review to examine patient and provider attitudes toward and engagement in SDM in the USA. Searches in PubMed and PsycINFO identified 1585 articles published between July 2006 and December 2016, of which 290 were screened in for coding and analysis. We found that patients and providers have generally positive attitudes toward SDM, but actual engagement in SDM behavior is lagging. Translation of positive attitudes into behavior could be achieved through policies that support key SDM processes of sharing evidence, considering patient preferences and discussing the relative advantages of different clinical options.

摘要

为使比较效果研究切实有效,患者和医疗服务提供者必须在共同决策(SDM)中开展协作,以做出符合患者偏好的循证临床决策。我们进行了一项系统综述,以考察美国患者和医疗服务提供者对共同决策的态度以及参与共同决策的情况。在PubMed和PsycINFO数据库中进行检索,共识别出2006年7月至2016年12月期间发表的1585篇文章,其中290篇被筛选出来进行编码和分析。我们发现,患者和医疗服务提供者对共同决策总体持积极态度,但实际参与共同决策行为的情况却滞后。通过支持共享证据、考虑患者偏好以及讨论不同临床选项相对优势等关键共同决策过程的政策,可将积极态度转化为实际行为。

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