Official websites use. Share sensitive information only on official, secure websites. Shared decision making SDM is a process by which a healthcare choice is made by the patient, significant others, or both with one or more healthcare professionals. However, it has not yet been widely adopted in practice. This is the second update of this Cochrane review. To determine the effectiveness of interventions for increasing the use of SDM by healthcare professionals. We considered interventions targeting patients, interventions targeting healthcare professionals, and interventions targeting both.
We also searched two clinical trials registries and proceedings of relevant conferences. We checked reference lists and contacted study authors to identify additional studies. We included 87 studies 45, patients and healthcare professionals conducted mainly in the USA, Germany, Canada and the Netherlands. Risk of bias was high or unclear for protection against contamination, low for differences in the baseline characteristics of patients, and unclear for other domains.
They included decision aids, patient activation, question prompt lists and training for patients among others and were administered alone single intervention or in combination multifaceted intervention. The certainty of the evidence was very low.
It is uncertain if interventions targeting patients when compared with usual care increase SDM whether measured by observation standardized mean difference SMD 0. It is uncertain if interventions targeting patients when compared with interventions of the same type increase SDM whether measured by observation SMD 0.
Fifteen studies evaluated interventions targeting healthcare professionals. They included educational meetings, educational material, educational outreach visits and reminders among others.
