Shared Decision Making and Patient Decision Aids: Knowledge, Attitudes, and Practices Among Hawai‘i Physicians

摘要

This analysis suggests that physicians in Hawai‘i share similar, but widely diverse attitudes towards the use of DAs than those reported in related studies.18–20 At 13.2%, use of DAs in Hawai‘i appears to be substantially lower than the 43% figure reported in a recent national survey of 402 primary care physicians.21 Understanding possible reasons for lower diffusion of DAs among Hawai‘i physicians appears warranted. Of Hawai‘i physicians sampled in this study, the leading barriers to the implementation of DAs in clinical practice were lack of awareness and limited resources. These responses are similar to a recent study by King, et al, on perceptions of SDM among rural primary care clinicians, in which a majority of the respondents was unfamiliar with the term “shared decision making” and what it entailed.22 However, King, et al, found that despite low general awareness, most physicians surveyed recognized the value of SDM and were open to the use of DAs in multiple formats. Similarly, our survey indicated that while awareness of DAs remains low, Hawai‘i physicians recognized the importance of SDM and are highly receptive to the use of DAs, especially computer- and print-based formats. Recognition of the benefits of interactive online DAs by Hawai‘i physicians is particularly interesting since a growing body of literature suggests that computer-based DAs can facilitate SDM and more effectively improve patient knowledge and satisfaction, especially among patients with low literacy skills compared to other decision support tools.10,23–26 The positive responses toward SDM and the use of DAs are promising since recent federal and state level policies adopt and expand the use of SDM as part of an overall strategy to improve health care quality and patient experience.27,28