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Barriers and facilitators for shared decision making in older patients with multiple chronic conditions: a systematic review
BACKGROUND: The aim of this study was to describe barriers and facilitators for shared decision making (SDM) as experienced by older patients with multiple chronic conditions (MCCs), informal caregivers and health professionals. METHODS: A structured literature search was conducted with 5 databases....
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7866443/ https://www.ncbi.nlm.nih.gov/pubmed/33549059 http://dx.doi.org/10.1186/s12877-021-02050-y |
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author | Pel-Littel, Ruth E. Snaterse, Marjolein Teppich, Nelly Marela Buurman, Bianca M. van Etten-Jamaludin, Faridi S. van Weert, Julia C. M. Minkman, Mirella M. Scholte op Reimer, Wilma J. M. |
author_facet | Pel-Littel, Ruth E. Snaterse, Marjolein Teppich, Nelly Marela Buurman, Bianca M. van Etten-Jamaludin, Faridi S. van Weert, Julia C. M. Minkman, Mirella M. Scholte op Reimer, Wilma J. M. |
author_sort | Pel-Littel, Ruth E. |
collection | PubMed |
description | BACKGROUND: The aim of this study was to describe barriers and facilitators for shared decision making (SDM) as experienced by older patients with multiple chronic conditions (MCCs), informal caregivers and health professionals. METHODS: A structured literature search was conducted with 5 databases. Two reviewers independently assessed studies for eligibility and performed a quality assessment. The results from the included studies were summarized using a predefined taxonomy. RESULTS: Our search yielded 3838 articles. Twenty-eight studies, listing 149 perceived barriers and 67 perceived facilitators for SDM, were included. Due to poor health and cognitive and/or physical impairments, older patients with MCCs participate less in SDM. Poor interpersonal skills of health professionals are perceived as hampering SDM, as do organizational barriers, such as pressure for time and high turnover of patients. However, among older patients with MCCs, SDM could be facilitated when patients share information about personal values, priorities and preferences, as well as information about quality of life and functional status. Informal caregivers may facilitate SDM by assisting patients with decision support, although informal caregivers can also complicate the SDM process, for example, when they have different views on treatment or the patient’s capability to be involved. Coordination of care when multiple health professionals are involved is perceived as important. CONCLUSIONS: Although poor health is perceived as a barrier to participate in SDM, the personal experience of living with MCCs is considered valuable input in SDM. An explicit invitation to participate in SDM is important to older adults. Health professionals need a supporting organizational context and good communication skills to devise an individualized approach for patient care. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-021-02050-y. |
format | Online Article Text |
id | pubmed-7866443 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-78664432021-02-08 Barriers and facilitators for shared decision making in older patients with multiple chronic conditions: a systematic review Pel-Littel, Ruth E. Snaterse, Marjolein Teppich, Nelly Marela Buurman, Bianca M. van Etten-Jamaludin, Faridi S. van Weert, Julia C. M. Minkman, Mirella M. Scholte op Reimer, Wilma J. M. BMC Geriatr Review BACKGROUND: The aim of this study was to describe barriers and facilitators for shared decision making (SDM) as experienced by older patients with multiple chronic conditions (MCCs), informal caregivers and health professionals. METHODS: A structured literature search was conducted with 5 databases. Two reviewers independently assessed studies for eligibility and performed a quality assessment. The results from the included studies were summarized using a predefined taxonomy. RESULTS: Our search yielded 3838 articles. Twenty-eight studies, listing 149 perceived barriers and 67 perceived facilitators for SDM, were included. Due to poor health and cognitive and/or physical impairments, older patients with MCCs participate less in SDM. Poor interpersonal skills of health professionals are perceived as hampering SDM, as do organizational barriers, such as pressure for time and high turnover of patients. However, among older patients with MCCs, SDM could be facilitated when patients share information about personal values, priorities and preferences, as well as information about quality of life and functional status. Informal caregivers may facilitate SDM by assisting patients with decision support, although informal caregivers can also complicate the SDM process, for example, when they have different views on treatment or the patient’s capability to be involved. Coordination of care when multiple health professionals are involved is perceived as important. CONCLUSIONS: Although poor health is perceived as a barrier to participate in SDM, the personal experience of living with MCCs is considered valuable input in SDM. An explicit invitation to participate in SDM is important to older adults. Health professionals need a supporting organizational context and good communication skills to devise an individualized approach for patient care. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-021-02050-y. BioMed Central 2021-02-06 /pmc/articles/PMC7866443/ /pubmed/33549059 http://dx.doi.org/10.1186/s12877-021-02050-y Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Review Pel-Littel, Ruth E. Snaterse, Marjolein Teppich, Nelly Marela Buurman, Bianca M. van Etten-Jamaludin, Faridi S. van Weert, Julia C. M. Minkman, Mirella M. Scholte op Reimer, Wilma J. M. Barriers and facilitators for shared decision making in older patients with multiple chronic conditions: a systematic review |
title | Barriers and facilitators for shared decision making in older patients with multiple chronic conditions: a systematic review |
title_full | Barriers and facilitators for shared decision making in older patients with multiple chronic conditions: a systematic review |
title_fullStr | Barriers and facilitators for shared decision making in older patients with multiple chronic conditions: a systematic review |
title_full_unstemmed | Barriers and facilitators for shared decision making in older patients with multiple chronic conditions: a systematic review |
title_short | Barriers and facilitators for shared decision making in older patients with multiple chronic conditions: a systematic review |
title_sort | barriers and facilitators for shared decision making in older patients with multiple chronic conditions: a systematic review |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7866443/ https://www.ncbi.nlm.nih.gov/pubmed/33549059 http://dx.doi.org/10.1186/s12877-021-02050-y |
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