Shared decision making (SDM), the dialogue between healthcare providers and patients and/or patients’ caregivers regarding treatment options, has been shown to increase patient engagement and reduce healthcare costs. SDM has been found to be particularly effective in scenarios involving preference-sensitive conditions (those for which the clinical evidence does not clearly support one treatment option and the appropriate course of treatment depends on the values or preferences of the patient) and palliative care. SDM helps to assure that tests, treatment and care will be based on clinical evidence that balances risks and expected outcomes with patient preferences and values.
SDM discussions generally involve the use of decision aids (e.g., flyers, videos, charts), which explain different treatment choices, with their risks and benefits. During an SDM discussion, you can use a decision aid to facilitate the dialogue about different treatment options and share your clinical expertise; your patient and/or a caregiver will also share the patient’s goals, priorities and values. After weighing the different treatment options and discussing the patient’s goals and values, you and your patient and/or his or her caregiver will make the treatment decision together.
SDM is particularly important in serious and chronic illness because treatment decisions are highly sensitive to preference. Helping patients and their caregivers understand their treatment choices can help patients get the care that they prefer and that aligns most closely with their life goals.
Palliative care, also known as supportive care or symptom management, is a care approach used to ease pain and discomfort in patients living with chronic or serious illnesses to increase their quality of life. Patients getting palliative care can still have medical treatments that might cure the illness while implementing specialized care for symptom relief. Palliative care is not the same as hospice care, which is offered when patients are considered to be terminally ill and are no longer receiving treatment for their illnesses.
In March 2020, FAIR Health, with support from The New York Community Trust, launched a new feature on its consumer website, fairhealthconsumer.org, to give patients free access to decision aids that have both treatment and cost information.
SDM decision aids are available for patients, and caregivers of patients, who may need:
You can use the decision aids in your discussions with patients who are seriously ill and/or their caregivers. The decision aids are not intended to be medical advice, diagnosis or treatment. They are intended to provide information to help you and your patients engage in shared decision making.
Please refer to the Patient Educational Content section to learn more about our resources for patients.