Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Dr, Ste 401, Boston, MA, 02215, USA.
Beth Israel Deaconess Medical Center, Division of Infectious Diseases, 110 Francis St., W/LMOB Suite GB, Boston, MA, 02215, USA.
Curr HIV/AIDS Rep. 2021 Feb;18(1):48-56. doi: 10.1007/s11904-020-00535-w. Epub 2021 Jan 8.
Shared decision-making is a process that involves bidirectional exchange of information between patients and providers to support patients in making individualized, evidence-based decisions about their healthcare. We review the evidence on patient-led decision-making, a form of shared decision-making that maximizes patient autonomy, as a framework for decisions about HIV preexposure prophylaxis (PrEP). We also assess the likelihood that patient-led decision-making occurs for PrEP and describe interventions to facilitate this process.
Patient-led decision-making is likely to be uncommon for PrEP, in part because healthcare providers lack knowledge and training about PrEP. Few evidence-based interventions exist to facilitate patient-led decision-making for PrEP. There is a need for rigorously developed interventions to increase knowledge of PrEP among patients and healthcare providers and support patient-led decision-making for PrEP, which will be increasingly important as the range of available PrEP modalities expands.
共同决策是一个涉及医患双方双向信息交流的过程,旨在帮助患者针对其医疗保健做出个体化、基于证据的决策。我们回顾了以患者为主导的决策(一种最大限度地提高患者自主性的共同决策形式)作为艾滋病毒暴露前预防 (PrEP) 决策的框架的证据。我们还评估了 PrEP 中以患者为主导的决策发生的可能性,并描述了促进这一过程的干预措施。
PrEP 中以患者为主导的决策可能不太常见,部分原因是医疗保健提供者对 PrEP 的知识和培训不足。很少有循证干预措施可以促进 PrEP 的以患者为主导的决策。需要开发严格的干预措施,以提高患者和医疗保健提供者对 PrEP 的认识,并支持 PrEP 的以患者为主导的决策,随着可用 PrEP 方式的范围扩大,这将变得越来越重要。