Can Grandma Be Involved in Her Next Clinical Decision?
This post summarizes the paper “An Exploratory Study of Shared Decision-Making (SDM) for Older Adult Patients with Chronic Diseases” published in CSCW 2023.
Shared decision-making (SDM) is a central feature of clinical practice guidelines, and it is a key way to improve long-term communication and relationships between older adult patients and physicians. The #CSCW2023 poster paper showcases a research project by Cornell University researchers aiming to explore factors that encourage aging populations to engage and participate in their clinical decision-making process through information technology.
Previous studies have found that patients’ engagement in decision-making is closely associated with patient satisfaction and improved treatment outcomes. However, medical decision-making can be complex. This difficulty has only increased in recent years with the increasing shift toward telehealth, with reduced patient–clinician contact times, and with the impact of the Covid-19 pandemic and other stresses on the healthcare system.
Healthcare often requires time-sensitive decisions, and when confronted with multiple possible treatments, it is necessary to assess the impact of each treatment on health outcomes carefully and consider potential harms and benefits. Effective communication tools can be useful for conducting this assessment in a shared fashion.
Hao et al. conducted interviews with 12 participants, including seven older adults with chronic diseases and five clinicians who work with this aging patient population, with the goal of better understanding both groups’ perspectives and needs in the clinical setting. The interviews focused on the potential benefits derived from an SDM-based technological platform. Combining the interview results from the older adult patients and the clinicians, they identified 10 factors the participants believed were important to include when presenting information about patient treatment options.
In this study, the clinicians and older adult patients supported the SDM approach and felt that information technology had a valuable role in enhancing SDM. However, obstacles such as the distrust of the healthcare system, medical knowledge barriers, and urgent time have made it challenging to engage aging populations in the SDM process. Older adult patients may feel neglected or lack self-confidence when directed to the SDM process. The study highlights the need for larger systemic changes to ensure a stronger clinician-patient relationship and how SDM could potentially become a win-win solution, especially for older adult patients with chronic diseases.
Please cite the full work: Yuexing Hao, Zeyu Liu, Monika Safford, Rulla Tamimi, and Saleh Kalantari. 2023. An Exploratory Study of Shared Decision-Making (SDM) for Older Adult Patients with Chronic Diseases. In Computer Supported Cooperative Work and Social Computing (CSCW ’23 Companion), October 14–18, 2023, Minneapolis, MN, USA. ACM, New York, NY, USA, 5 pages. https://doi.org/ 10.1145/3584931.3607023.
