THE ROLE OF PATIENT VALUE AND PATIENT-CENTRED
CARE IN HEALTH SYSTEMSoutcomes. On the other hand, a link between
shared decision-making and higher levels of
patient satisfaction and understanding did
come through. These are not lesser cousins
to traditional clinical results. As one advisory
board member put it, “clinical outcomes are
important, but personal goals and aspirations
matter too.”
Notably, in the 2015 review shared decision-
making’s benefits occurred only when the
patients believed that they had shared in the
decision. Research that looked at results where
only clinicians identified whether shared
decision-making had taken place showed no
improvement over the norm. In other words,
patients genuinely have to feel part of the
process for it to be helpful. “The challenge
with these findings,” the study concluded, “is
that we do not know what leads a patient to
report a decision as shared, and thus do not
know how to foster shared decision-making
and its associated benefits in practice.”^29 They
probably need to ask the experts: patients.- L Shay and J Lafata, “Where is the
evidence? A systematic review of shared
decision making and patient outcomes,”
Medical Decision Making, 2015.