Shared decision-making and decision support: Their role in obstetrics and gynecology

Research output: Contribution to journalReview article

11 Scopus citations

Abstract

Purpose of review To discuss the role for shared decision-making in obstetrics/gynecology and to review evidence on the impact of decision aids on reproductive health decision-making. Recent findings Among the 155 studies included in a 2014 Cochrane review of decision aids, 31 (29%) addressed reproductive health decisions. Although the majority did not show evidence of an effect on treatment choice, there was a greater uptake of mammography in selected groups of women exposed to decision aids compared with usual care; and a statistically significant reduction in the uptake of hormone replacement therapy among detailed decision aid users compared with simple decision aid users. Studies also found an effect on patient-centered outcomes of care, such as medication adherence, quality-of-life measures, and anxiety scores. In maternity care, only decision analysis tools affected final treatment choice, and patient-directed aids yielded no difference in planned mode of birth after cesarean. Summary There is untapped potential for obstetricians/gynecologists to optimize decision support for reproductive health decisions. Given the limited evidence-base guiding practice, the preference-sensitive nature of reproductive health decisions, and the increase in policy efforts and financial incentives to optimize patients' satisfaction, it is increasingly important for obstetricians/gynecologists to appreciate the role of shared decision-making and decision support in providing patient-centered reproductive healthcare.

Original languageEnglish (US)
Pages (from-to)523-530
Number of pages8
JournalCurrent Opinion in Obstetrics and Gynecology
Volume26
Issue number6
DOIs
StatePublished - Jan 1 2014

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Keywords

  • Decision aids
  • Patient-centered care
  • Patient-clinician communication
  • Shared decision-making

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Medicine(all)

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