Posting date: October 7, 2004

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Health Affairs, 10.1377/hlthaff.var.63
Copyright © 2004 by Project HOPE

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Modifying Unwarranted Variations In Health Care: Shared Decision Making Using Patient Decision Aids

¹ Annette O’Connor is a Tier 1 Canada Research Chair in Health Care Consumer Decision Support and a professor at the University of Ottawa (Ontario), and a senior scientist with the Ottawa Health Research Institute.
² Hilary Llewellyn-Thomas is a professor in the Department of Community and Family Medicine, Dartmouth Medical School, and faculty in the Center for the Evaluative Clinical Sciences at Dartmouth in Hanover, New Hampshire.
³ Ann Barry Flood holds these same appointments at Dartmouth and is a professor in the Department of Sociology, Dartmouth College.

^*Corresponding author.

Abstract

Shared decision making is the process of interacting with patients in arriving at informed values-based choices when options have features that patients value differently. Patient decision aids (PtDAs) are evidence-based tools designed to facilitate that process. Numerous randomized trials indicate that PtDAs improve decision quality and prevent overuse of options that informed patients do not value. Therefore, they have a potential role in reducing unwarranted variations in the use of preference-sensitive health care options. However, barriers to their widespread use need to be addressed with coherent plans for ensuring good standards, improving access to PtDAs, training practitioners, testing practice models, and launching demonstration projects.

Key Words: Chronic Care, Consumer Issues, Quality Of Care, Variations

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