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The Potential of Shared Decision Making to Reduce Health Disparities

Published online by Cambridge University Press:  01 January 2021

Jaime S. King ,
Mark H. Eckman  and
Benjamin W. Moulton
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Extract

Current methods of obtaining an informed consent leave much to be desired. Patients rarely read consent forms or understand all of the risks, benefits, or alternatives associated with their treatment. Evaluating the advantages and disadvantages of treatment options often presents a more significant challenge for patients with lower levels of health literacy. This article reviews the evidence of shortcomings in our informed consent system and then explores the potential for a new approach to engage patients at all levels of health literacy in their treatment decisions. Specifically, the article will examine the potential of shared decision-making (SDM) to bridge gaps in knowledge, increase patient adherence to treatment, and improve health outcomes in low health literacy patient populations. Leveling barriers to treatment information for disadvantaged populations should be a public health imperative, especially if it can be shown to improve health outcomes and reduce health disparities.

Type
JLME Supplement
Information
Journal of Law, Medicine & Ethics , Volume 39 , Issue S1 , Spring 2011 , pp. 30 - 33
Copyright
Copyright © American Society of Law, Medicine and Ethics 2011

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References

Lavelle-Jones, C., Byrne, D. J., and Cushieri, A., “Factors Affecting Quality of Informed Consent,” BMJ 306, no. 6882 (1993): 885–890.CrossRefGoogle Scholar
Bottrell, M. M., Alpert, H., Fishbach, R. L., Emmanuel, L. L., “Hospital Informed Consent Forms: Facilitating Quality Patient Physician Interaction,” Archives of Surgery 135, no. 1 (2000): 26–33.CrossRefGoogle Scholar
See Lavelle-Jones, et al., supra note 1.Google Scholar
Zikmund-Fisher, B. J., Couper, M. P., Singer, E., Levin, C. A., Fowler, F. J., Ziniel, S., Ubel, P. A., and Fagerlin, A., “The DECISIONS Study: A Nationwide Survey of United States Adults Regarding 9 Common Medical Decisions,” Medical Decision Making 30 (2010): 20S–34S.CrossRefGoogle Scholar
Faigerlin, A., Sepucha, K. R., Couper, M. P., Levin, C. A., Singer, E., and Zikmund-Fisher, B. J., “Patients’ Knowledge about 9 Common Health Conditions: The DECISIONS Survey,” Medical Decision Making 30 (2010): 35S–52S.CrossRefGoogle Scholar
Id.Google Scholar
Sepucha, K. R., Faigerlin, A., Couper, M. P., Levin, C. A., Singer, E., and Zikmund-Fisher, B. J., Medical Decision Making 30 (2010): 77S–84S.CrossRefGoogle Scholar
King, J. S. and Moulton, B. W., “Rethinking Informed Consent: The Case for Shared Decision-Making,” American Journal of Law & Medicine 32, no. 4 (2006): 429–501; Kaplan, R. M., “Shared Medical Decision Making: A New Tool for Preventative Medicine,” American Journal of Preventative Medicine 26 (2003): 81.CrossRefGoogle Scholar
O’Connor, A. M., Bennett, C. L., Stacey, D., and Barry, M. et al., “Decision Aids for People Facing Health Treatment or Screening Decisions,” Cochrane Database of Systematic Reviews 3 (2009), available at <http://decisionaid.ohri.ca/cochsystem.html> (last visited November 15, 2010).CrossRefGoogle Scholar
Volandes, A. E., Paasche-Orlow, M. K., and Barry, M. J. et al., “Video Decision Support Tool for Advance Care Planning in Dementia: Randomised Controlled Trial,” BMJ 338 (2009): B2159; Meade, C. D., McKinney, W. P., and Barnas, G. P., “Educating Patients with Limited Literacy Skills: The Effectiveness of Printed and Videotaped Materials About Colon Cancer,” American Journal of Public Health 84, no. 1 (1994): 119–1121; Davis, T. C., Berkel, H. J., Arnold, C. L., Nandy, I., Jackson, R. H., and Murphy, P. W., “Intervention to Increase Mammography Utilization in a Public Hospital,” Journal of General Internal Medicine 13, no. 4 (1998): 230–2333.CrossRefGoogle Scholar
Eckman, M. H., Wise, R., Leonard, A. C., Dixon, E., Burrows, C., Khan, F., and Warm, E., “Impact of Health Literacy on Outcomes and Effectiveness of An Educational Intervention in Patients with Chronic Diseases,” Journal of General Internal Medicine (under review, 2010); Frosch, D. L., Singer, K. J., and Timmermans, S., “Conducting Implementation Research in Community-Based Primary Care: A Qualitative Study on Integrating Patient Decision Support Interventions for Cancer Screening into Routine Practice,” Health Expectations (November 10, 2009).Google Scholar
See O’Connor, et al., supra note 9.Google Scholar
Hibbard, J. H., Peters, E., and Dixon, A. et al., “Consumer Competencies and the Use of Comparative Quality Information: It Isn’t Just about Literacy,” Medical Care Research and Review 64, no. 4 (2007): 379–394; Guadagnoli, E. and Ward, P., “Patient Participation in Decision-Making,” Social Science Medicine 47, no. 3 (1998): 329–339; Kaplan, S. H. et al., “Assessing the Effects of Physician-Patient Interactions on the Outcomes of Chronic Disease,” Medical Care 27, no. 3 (1989): S110–S127; Mendonca, P. and Brehm, S., “Effects of Choice on Behavioral Treatment of Overweight Children,” Journal of Social Clinical Psychology 1, no. 4 (1983): 343–358; Schulman, B. A., “Active Patient Orientation and Outcomes in Hypertensive Treatment,” Medical Care 17, no. 3 (1979): 267–280.CrossRefGoogle Scholar
See Frosch, et al., supra note 11.Google Scholar
Arora, N. K. and McHorney, C. A., “Patient Preferences for Medical Decisions Making: Who Really Wants to Participate?” Medical Care 38, no. 3 (2000): 335–341; Deber, R. B., Kraetschmer, N., and Irvine, J., “What Role Do Patients Wish to Play in Treatment Decision Making?” Archives of Internal Medicine 156 (1996): 1414–1420; Levinson, W., Kao, A., Kuby, A., and Thisted, R. A., “Not all Patients Want to Participate in Decision Making,” JGIM 20 (2005): 531–535.CrossRefGoogle Scholar
Dewalt, D. A., Berkman, N. D., Sheridan, S., Lohr, K. N., and Pignone, M. P., “Literacy and Health Outcomes: A Systematic Review of the Literature,” Journal of General Internal Medicine 19, no. 12 (2004): 1228–1239; Williams, M. V., Parker, R. M., and Baker, D. W. et al., “Inadequate Functional Health Literacy among Patients at Two Public Hospitals,” JAMA 274, no. 21 (1995): 1677–1682.Google Scholar
Kalichman, S. C. and Rompa, D., “Functional Health Literacy Is Associated with Health Status and Health-Related Knowledge in People Living with HIV-AIDS,” Journal of Acquired Immune Deficiency Syndromes 25, no. 4 (2000): 337–344; Sudore, R. L., Yaffe, K., and Satterfield, S. et al., “Limited Literacy and Mortality in the Elderly: The Health, Aging, and Body Composition Study,” Journal of General Internal Medicine 21, no. 8 (2006): 806–812; Weiss, B. D., Hart, G., McGee, D. L., and D’Estelle, S., “Health Status of Illiterate Adults: Relation Between Literacy and Health Status among Persons with Low Literacy Skills,” Journal of American Board of Family Practice 5, no. 3 (1992): 257–264; Wolf, M. S., Gazmararian, J. A., and Baker, D. W., “Health Literacy and Functional Health Status among Older Adults,” Archives of Internal Medicine 165, no. 17 (2005): 1946–1952.CrossRefGoogle Scholar
Baker, D. W., Wolf, M. S., Feinglass, J., Thompson, J. A., Gazmararian, J. A., and Huang, J., “Health Literacy and Mortality among Elderly Persons,” Archives of Internal Medicine 167, no. 14 (2007): 1503–1509.CrossRefGoogle Scholar
See Eckman, , supra note 11; Frosch, , supra note 11.Google Scholar
See Eckman, , supra note 11.Google Scholar
Davis, T. C., Bocchini, J. A. Jr., and Fredrickson, D. et al., “Parent Comprehension of Polio Vaccine Information Pamphlets,” Pediatrics 97, no. 6, Pt. 1 (1996): 804–810; Eaton, M. L. and Holloway, R. L., “Patient Comprehension of Written Drug Information,” American Journal of Hospital Pharmacy 37, no. 2 (1980): 240–243; Davis, T. C., Holcombe, R. F., Berkel, H. J., Pramanik, S., and Divers, S. G., “Informed Consent for Clinical Trials: A Comparative Study of Standard versus Simplified Forms,” Journal of National Cancer Institute 90, no. 9 (1998): 668–674; Michielutte, R., Bahnson, J., Dignan, M. B., and Schroeder, E. M., “The Use of Illustrations and Narrative Text Style to Improve Readability of a Health Education Brochure,” Journal of Cancer Education 7, no. 3 (1992): 251–260.Google Scholar
Coleman, E. A., Coon, S., and Mohrmann, C. et al., “Developing and Testing Lay Literature about Breast Cancer Screening for African American Women,” Clinical of Journal Oncological Nursing 7, no. 1 (2003): 66–71; Winkleby, M. A., Howard-Pitney, B., Albright, C. A., Bruce, B., Kraemer, H. C., and Fortmann, S. P., “Predicting Achievement of a Low-Fat Diet: A Nutrition Intervention for Adults with Low Literacy Skills,” Preventative Medicine 26, no. 6 (1997): 874–882; Hussey, L. C., Minimizing, “Effects of Low Literacy on Medication Knowledge and Compliance among the Elderly,” Clinical Nursing Research 3, no. 2 (1994): 132–145; Murphy, P. W., Davis, T. C., Mayeaux, E. J., Sentell, T., Arnold, C., and Rebouche, C., “Teaching Nutrition Education in Adult Learning Centers: Linking Literacy, Health Care, and the Community,” Journal of Community Health Nursing 13, no. 3 (1996): 149–158; Hartman, T. J., McCarthy, P. R., Park, R. J., Schuster, E., Kushi, L. H., “Results of a Community-Based Low-Literacy Nutrition Education Program,” Journal of Community Health 22, no. 5 (1997): 325–341; Kumanyika, S. K., Adams-Campbell, L., and Van Horn, B. et al., “Outcomes of a Cardiovascular Nutrition Counseling Program in African-Americans with Elevated Blood Pressure or Cholesterol Level,” Journal of the American Diet Association 99, no. 11 (1999): 1380–1391.CrossRefGoogle Scholar
Howard-Pitney, B., Winkleby, M. A., Albright, C. L., Bruce, B., and Fortmann, S. P., “The Stanford Nutrition Action Program: A Dietary Fat Intervention for Low-Literacy Adults,” American Journal of Public Health 87, no. 12 (1997): 1971–1976.CrossRefGoogle Scholar
See Zikmund-Fisher, et al., supra note 4.Google Scholar