Boston, MA—Last week at the 2017 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS), the results of a recent prospective studyshed new light on the importance of shared decision making in elective surgeries. According to its authors, “evidence from this study suggests that well-informed patients who receive their preferred treatment have higher satisfaction and small improvements in health outcomes.” This is exciting news for healthcare professionals everywhere. Clinical guidelines and patient advocates have stressed the importance of shared decision making for years, but few studies have adequately assessed the approach’s impact on overall health outcomes.
Let’s start with a little background: in a nutshell, shared decision making is the approach in which HCPs and patients work together to arrive at healthcare decisions. Ideally, the former provides clinical evidence in patient-friendly terms, and the latter shares their values and preferences. Together they agree and move forward with a tailored treatment plan.
In order to assess this process’s impact on outcomes, the study surveyed more than 550 patients plagued with osteoarthritis of their knee or hip, a herniated (slipped or ruptured) disc in their lower back (LDH), or lumbar spinal stenosis (LSS). First, a baseline was established for each patient: researchers evaluated how well each patient understood his or her condition and also assessed quality of life, surgical preferences, physical limitations, and pain. According to the study’s authors, “Patients with a passing knowledge score (60% or higher) who received their preferred treatment (either surgery or nonsurgical) were considered to have made an informed, patient-centered (IPC) decision.” Finally, a follow-up questionnaire was administered six months after either surgery or initial office visit (for patients receiving nonsurgical treatment).
When the researchers compared the results from the final questionnaires to the baseline assessments, the results were striking. One-third of those enrolled were deemed to have made an informed, patient-centered decision, and when compared to those who did not qualify for the classification, the IPC group demonstrated “significantly better overall and disease-specific quality of life across all topics.” Additionally, they were also more than twiceas likely to be very or extremely satisfied with their treatments and had three times less regret regarding their decision.
Why This Matters—
This news sits at the crossroads of two of our 2017 Trends in our Healthcare report:
Still Don’t Get It
Health literacy is back the spotlight. The perennial challenge of helping people better understand and navigate health and healthcare has gained new urgency as payers have taken stronger control of the options available to patients and as questions of efficacy and value have become more complex. Healthcare professionals and advocates around the world want to give patients more control of their health by improving their knowledge regarding what to expect and how to make better choices. In 2017, look for a drive for simplicity in communications and a groundswell of conversation about how to decode healthcare for the people who need the knowledge the most.
The shift to outcomes-based metrics has finally put the spotlight on the member of the healthcare team most able to drive persistency and commitment: the patient. Providers are making significant investments in patient engagement and activation programs. They’re stratifying populations not just by health risk but by level of engagement. Research backs up those moves with proof that consistently shows that patients who are more involved in the self-management of their health are less likely to be hospitalized or to develop a chronic condition than those with lower engagement scores.
The results from this study provide yet another proof point supporting these trends—health literacy and patient engagement are both essential to improving health outcomes and overall satisfaction. Today’s healthcare brands have a unique opportunity to further advance shared decision making by translating complex health information into digestible forms and empowering the patient-HCP relationship.