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Kunneman M, Branda ME, Hargraves I, et al. Fostering Choice Awareness for Shared Decision Making: A Secondary Analysis of Video-Recorded Clinical Encounters. Mayo Clin Proc Innov Qual Outcomes. 2018;2(1):60-68doi: 10.1016/j.mayocpiqo.2017.12.002.
Kunneman, M., Branda, M. E., Hargraves, I., Pieterse, A. H., & Montori, V. M. (2018). Fostering Choice Awareness for Shared Decision Making: A Secondary Analysis of Video-Recorded Clinical Encounters. Mayo Clinic proceedings. Innovations, quality & outcomes, 2(1), 60-68. https://doi.org/10.1016/j.mayocpiqo.2017.12.002
Kunneman, Marleen, et al. "Fostering Choice Awareness for Shared Decision Making: A Secondary Analysis of Video-Recorded Clinical Encounters." Mayo Clinic proceedings. Innovations, quality & outcomes vol. 2,1 (2018): 60-68. doi: https://doi.org/10.1016/j.mayocpiqo.2017.12.002
Kunneman M, Branda ME, Hargraves I, Pieterse AH, Montori VM. Fostering Choice Awareness for Shared Decision Making: A Secondary Analysis of Video-Recorded Clinical Encounters. Mayo Clin Proc Innov Qual Outcomes. 2018 Feb 01;2(1):60-68. doi: 10.1016/j.mayocpiqo.2017.12.002. eCollection 2018 Mar. PMID: 30225433; PMCID: PMC6124329.
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Mayo Clin Proc Innov Qual Outcomes. 2018 Feb 01;2(1):60-68. doi: 10.1016/j.mayocpiqo.2017.12.002. eCollection 2018 Mar.

Fostering Choice Awareness for Shared Decision Making: A Secondary Analysis of Video-Recorded Clinical Encounters.

Mayo Clinic proceedings. Innovations, quality & outcomes

Marleen Kunneman, Megan E Branda, Ian Hargraves, Arwen H Pieterse, Victor M Montori

Affiliations

  1. Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN.
  2. Department of Medical Decision Making, Leiden University Medical Center, Leiden, the Netherlands.
  3. Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.

PMID: 30225433 PMCID: PMC6124329 DOI: 10.1016/j.mayocpiqo.2017.12.002

Abstract

OBJECTIVE: To assess the extent to which (1) clinicians, using or not using conversation aids, foster choice awareness during clinical encounters and (2) fostering choice awareness, with or without conversation aids, is associated with greater patient involvement in shared decision making (SDM).

PATIENTS AND METHODS: We randomly selected 100 video-recorded encounters, stratified by topic and study arm, from a database of 10 clinical trials of SDM interventions in 7 clinical contexts: low-risk acute chest pain, stable angina, diabetes, depression, osteoporosis, and Graves disease. Reviewers, unaware of our hypothesis, coded recordings with the OPTION-12 scale to quantify the extent to which clinicians involved patients in decision making (SDM, 0-100 score). Blinded to OPTION-12 scale scores, we used a self-developed coding scale to code whether and how choice awareness was fostered.

RESULTS: Clinicians fostered choice awareness in 53 of 100 encounters. Fostering choice awareness was associated with a higher OPTION-12 scale score (adjusted [for using vs not using a conversation aid] predicted mean difference, 20; 95% CI, 11-29). Using a conversation aid was associated with a higher, nonsignificant chance of fostering choice awareness (N=31 of 50 [62%] vs N=22 of 50 [44%]; adjusted [for trial]

CONCLUSION: Fostering choice awareness is linked to a better execution of other SDM steps, such as informing patients or discussing preferences, even when SDM tools are not available or not used.

Keywords: SDM, shared decision making

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