Shared decision-making is a core approach to getting patients more involved in the treatment of their health conditions. Research in Health Affairs explores if and how decision aids used in that shared-decision making process effect patient choices. (HA Article) The authors used hip and knee osteoarthritis, common problems, especially among the elderly, as the test bed. Prior research has been inconsistent on whether use of decision aids led to fewer surgeries. The study was conducted by a group of ten health care systems who have banded together for research purposes. Adults who were exposed to decision aids were compared to those who were not over a three year period. The groups were matched on relevant characteristics. Other than exposure to the decision aid, typically a video or written material, the patients’ care in the intervention and control groups was the same. The primary outcome was whether or not the patient had hip or knee surgery in the 6 months following exposure to the decision aids. On an unadjusted basis, the intervention group had a 54% hip surgery rate versus 29% in the control group and a 32% knee surgery rate versus 24% in the controls. Adjustment on a number of characteristics reduced these differences somewhat but they remained significant. The authors concluded that exposure to the decision aids did not have a negative effect on the rate of surgeries, in fact the patients who viewed the decision aids appeared more likely to have a surgery. There are some limitations to the study in terms of understanding how patients reacted to the decision aids and what the total set of discussions with their treating physicians was. Surgeons are probably inclined to recommend surgery. One supposed rationale for shared decision-making is that it will ensure fidelity to patient preferences and will limit unnecessary procedures. Apparently patients may not be quick to think a procedure is unnecessary, even after exposure to extensive discussion about the risks and benefits. Even if involving patients in decision-making doesn’t reduce what some might deem to be unnecessary care, it is clearly the right thing to do.
✅ Subscribe via Email
About this Blog
The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at [email protected].
Healthy Skeptic Podcast
This is an outstanding report on total global drug spending and trends, with projections out to 2025. It helps you understand this important area of health care, which does much...
June 1, 2021
MedPAC 2019 Report to Congress
June 18, 2019
Mental health company Headway makes, well, headway, by raising an impressive $125 million round of new capital. The company connects patients with mental health providers and facilitates providers working with...
October 11, 2023
Two health care firms owned by private equity firms are merging in a transaction supposedly valued at $3 billion. HealthComp administers self-funded plans for employers and other groups and Virgin...
September 27, 2023
NextGen, an electronic medical records firm, is being put out of its public company misery, as a PE firm will pay $1.6 billion for the one-time high-flier.
September 7, 2023
Access ACO Care Management Chronic Disease Comparative Effectiveness Consumer Directed Health Consumers Devices Disease Management Drugs EHRs Elder Care End-of-Life Care FDA Financings Genomics Government Health Care Costs Health Care Quality Health Care Reform Health Insurance Health Insurance Exchange HIT HomeCare Hospital Hospital Readmissions Legislation M&A Malpractice Meaningful Use Medicaid Medical Care Medicare Medicare Advantage Mobile Pay For Performance Pharmaceutical Physicians Providers Regulation Repealing Reform Telehealth Telemedicine Wellness and Prevention Workplace