Interprofessional approaches to shared decision making (IP-SDM)

Abstract

The need to guide patients in their decision making is growing with the increasing number of clinical options and the more and more complex challenge to weigh the risks and the benefits of each of these options. The more difficult examples of decisions identified by the canadians include genetics tests (for example prenatal, BRCA1/2), the surgery (for example, treatment of the breast cancer or the prostate), the medication (for example, chemotherapy, medication for high blood pressure) and the care of the end of life. Furthermore, as the Canadian health policies aim to centered the primary health care on the patient, it entails the necessity of an interprofessional approach of care. The patient centered care is a philosophy of care where the patient' perspective is taking into account, while the interprofessionalism implies the collaboration between professionals of various disciplines to answer the need of the patients using an integrated approach in term of decision.The process by which a choice of health is made by practitioners in association with their patients is called shared decision-making. Until now, most of the researches on shared decision-making were concentrated only on the doctor-patient dyad and few researches were driven in the wider perspective of the interprofessional care. Consequently, the objective of this research is to enlarge the impact of shared decision-making in the interprofessional approach of care to meet the needs of canadians concerning primary health care services.

Shared decision making (SDM) is fundamental to informed consent and client-centered care. So far, SDM frameworks have been limited to the client-physician dyad, even though care is increasingly delivered by interprofessional (IP) teams. IP collaboration is especially essential in home care, one of health care's most rapidly growing areas.

We believe that developing tools to implement IP SDM in home care is essential to strengthening Canada's healthcare system and furthering patient-centered care. This study will contribute to the evaluation of IP SDM delivery models in home care. It will also generate practical, policy-oriented knowledge regarding the barriers and facilitators likely to influence the practice of IP SDM in home care.

Published Protocol:

A conceptual framework for interprofessional shared decision making in home care: protocol for a feasibility study. Légaré F, Stacey D, Brière N, Desroches S, Dumont S, Fraser K, Murray MA, Sales A, Aubé D. BMC Health Serv Res. 2011 Jan 31; 11: 23

Advancing theories, models and measurement for an interprofessional approach to shared decision making in primary care: a study protocol. Légaré, F., Stacey, D., Graham, I. D., Elwyn, G., Pluye, P., Gagnon, M. P., Frosch, D., Harrison, M. B., Kryworuchko, J., Pouliot, S., Desroches, S. BMC Health Services Research 2008, 8:2.

Publications:

Healthcare providers' intentions to engage in an interprofessional approach to shared decision-making in home care programs: A mixed methods study. Légaré F, Stacey D, Briere N, Fraser K, Desroches S, Dumont S, Sales A, Puma C, Aubé D. J Interprof Care. 2013 Feb 8

Interprofessionalism and shared decision making in primary care: a stepwise approach towards a new model. Légaré, F., Stacey, D., Pouliot, S., Gauvin, F.P., Desroches, S., Kryworuchko, J., Dunn, S., Elwyn, G., Frosch, D., Gagnon, M.P., Pluye, P., Graham, I.D. J. Interprof Care. 2011 Jan;25(1):18-25.

Validating a conceptual model for an inter-professional approach to shared decision making: a mixed methods study. Légaré, F., Stacey, D., Gagnon, S., Dunn, S., Pluye, P., Frosch, D., Kryworuchko, J., Elwyn, G., Gagnon, M.P., Graham, I.D. J Eval Clin Pract. 2011 Aug;17(4):554-64.

Interprofessional education for interprofessional practice about patients' decision support/patients' decision aids. Llewellyn-Thomas HA, Légaré F. J Interprof Care. 2011 Nov;25(6):399-400.

Shared decision making models to inform an interprofessional perspective on decision making: a theory analysis. Stacey D, Légaré F, Pouliot S, Kryworuchko J, Dunn S. Patient education and counseling. 2010 Aug;80(2):164-72.

Communications:

- Interprofessional Shared Decision Making (IP-SDM): Building knowledge and skills for use in practice - Workshop Outline - Sunday, March 27, 2011

- Implementing a conceptual framework for interprofessional shared decision making in home care: A feasibility study- Workshop ISDM 2011 conference- Maastricht June 19-22, 2011

Tools: Appendices

- IP-SDM Model

- Definitions of IP-SDM Model Concepts

- Definitions of IP Concepts

- Syllabus of the IP-SDM training workshop

- IP-SDMQuestionnaire

Funding: