The need to guide patients in their decision-making is growing with the increasing number of clinical options and the more and more complex challenge to weigh the risks and the benefits of each of these options. The more difficult examples of decisions identified by Canadians include genetics tests (e.g. prenatal, BRCA1/2), surgery (e.g. treatment of the breast cancer or the prostate), medication (e.g. chemotherapy, medication for high blood pressure), and the care of the end of life.
Furthermore, as the Canadian health policies aim to center primary health care on the patient, it entails the necessity of an interprofessional approach of care. The patient-centered care is a philosophy of care where the patient's perspective is taken into account while the interprofessionalism implies the collaboration between professionals of various disciplines to meet patients need using an integrated approach in term of decision. The process by which a health-related choice is made by practitioners in association with their patients is called shared decision-making. Until now, most of the researches on shared decision-making were concentrated only on the doctor–patient dyad and few researches were driven in the wider perspective of the interprofessional care. Consequently, the objective of this research is to enlarge the impact of shared decision-making in the interprofessional approach of care to meet the needs of Canadians concerning primary health care services.
Shared decision making (SDM) is fundamental to informed consent and patient-centered care. So far, SDM frameworks have been limited to the patient–physician dyad, even though care is increasingly delivered by interprofessional (IP) teams. IP collaboration is especially necessary in home care, one of health care's most rapidly growing areas.
We believe that developing tools to implement IP SDM in home care is essential to strengthening Canada's healthcare system and furthering patient-centered care. This study will contribute to the evaluation of IP SDM delivery models in home care. It will also generate practical, policy-oriented knowledge regarding the barriers and facilitators likely to influence the practice of IP SDM in home care.
A conceptual framework for interprofessional shared decision making in home care: protocol for a feasibility study. Légaré F, Stacey D, Brière N, Desroches S, Dumont S, Fraser K, Murray MA, Sales A, Aubé D. BMC Health Serv Res. 2011 Jan 31; 11: 23
Advancing theories, models and measurement for an interprofessional approach to shared decision making in primary care: a study protocol. Légaré, F., Stacey, D., Graham, I. D., Elwyn, G., Pluye, P., Gagnon, M. P., Frosch, D., Harrison, M. B., Kryworuchko, J., Pouliot, S., Desroches, S. BMC Health Serv 2008, 8:2.
An interprofessional approach to shared decision making: an exploratory case study with family caregivers of one IP home care team. Légaré F, Stacey D, Brière N, Robitaille H, Lord MC, Desroches S, Drolet R. BMC Geriatrics. 2014 Jul 2; 14:83.
A systematic process for creating and appraising clinical vignettes to illustrate interprofessional shared decision making. Stacey D, Brière N, Robitaille H, Fraser K, Desroches S, Légaré F. J Interprof Care. 2014 Apr 28.
Healthcare providers' intentions to engage in an interprofessional approach to shared decision-making in home care programs: A mixed methods study. Légaré F, Stacey D, Briere N, Fraser K, Desroches S, Dumont S, Sales A, Puma C, Aubé D. J Interprof Care. 2013 Feb 8
Interprofessionalism and shared decision making in primary care: a stepwise approach towards a new model. Légaré, F., Stacey, D., Pouliot, S., Gauvin, F.P., Desroches, S., Kryworuchko, J., Dunn, S., Elwyn, G., Frosch, D., Gagnon, M.P., Pluye, P., Graham, I.D. J. Interprof Care. 2011 Jan;25(1):18-25.
Validating a conceptual model for an inter-professional approach to shared decision making: a mixed methods study. Légaré, F., Stacey, D., Gagnon, S., Dunn, S., Pluye, P., Frosch, D., Kryworuchko, J., Elwyn, G., Gagnon, M.P., Graham, I.D. J Eval Clin Pract. 2011 Aug;17(4):554-64.
Interprofessional education for interprofessional practice about patients' decision support/patients' decision aids. Llewellyn-Thomas HA, Légaré F. J Interprof Care. 2011 Nov;25(6):399-400.
Shared decision making models to inform an interprofessional perspective on decision making: a theory analysis. Stacey D, Légaré F, Pouliot S, Kryworuchko J, Dunn S. Patient education and counseling. 2010 Aug;80(2):164-72.
- IP-SDM Model
- Definitions of IP-SDM Model Concepts
- Definitions of IP Concepts
- Syllabus of the IP-SDM training workshop