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Shared Decisions

American Heart Association Explains Importance of Shared Decision-Making

By Jonathan Springston, Editor, Relias Media

Instead of recommending physicians make all decisions for patients, the authors of a new scientific statement suggest decision-making should be a two-way street, with patients and multiple healthcare providers working together to create comprehensive treatment plans.

Called shared decision-making, the American Heart Association (AHA) recommends educating clinicians on communication techniques, engaging multidisciplinary medical teams, hiring trained coaches, and using decision aids to help patients make choices about their cardiovascular care. AHA believes this approach can improve engagement, raise the likelihood patients stick to the treatment plan, and possibly serve as a catalyst for health equity, ensuring everyone can access needed care.

“Broad endorsement of shared decision-making as a critical component of high-quality, value-based care has raised our awareness, although uptake in clinical practice remains suboptimal for a range of patient, clinician, and system issues,” the AHA statement authors wrote. “Multilevel solutions must align to address challenges in policies and reimbursement, system-level leadership and infrastructure, clinician training, access to decision aids, and patient engagement to fully support patients and clinicians to engage in the shared decision-making process and to drive equity and improvement in cardiovascular outcomes.”

Shared decision-making is not a new concept. The Agency for Healthcare Research and Quality created the five-step SHARE approach for all healthcare providers: Seek patient’s participation, Help patient explore treatment options, Assess patient’s preferences, Reach a decision, and Evaluate patient’s decision.

The Patient-Centered Outcomes Research Institute has invested more than $100 million in dozens of shared decision-making studies, all revealing this strategy improves patient satisfaction and leads to better outcomes. Shared decision-making can be beneficial in pediatrics, surgery, and even mitigate legal risks in emergency medicine settings.

“We've already made big strides in the last decade to improve shared decision-making overall,” Larry Allen, MD, a professor of medicine at the University of Colorado School of Medicine in Aurora and one of the AHA statement authors, said in a press release. “The statement, I think, recognizes that this has become mainstream, and attempts to move from concept to action."

For more on this and related subjects, be sure to read the latest issues of Clinical Cardiology Alert, Hospital Case Management, and Medical Ethics Advisor.