Barriers and Knowledge Gaps Regarding the Use of Decision Support Tools
Many providers believe they already practice shared decision making and need education on this technique and how it differs from patient education and informed consent. Providers also cite time as a barrier to implementation, however, studies show on average decision aids and shared decision making only add 2.5 minutes to the consultation.
LANGUAGE AND CULTURAL COMPETENCY
Many decision aids are only available in English. There is a growing field of research around the use of decision aids in diverse cultural settings that will help implementation efforts going forward.
There are no widely accepted metrics around shared decision making or use of decision aids.
Patients consistently desire more engagement in decision making. While vulnerable populations can be challenging to engage, for example homeless individuals and mailed decision aids, they are the most likely to benefit from increased engagement in decision making and should not be excluded from shared decision making efforts.
The evidence on the cost-effectiveness of implementing decision support tools and utilization is very limited and the findings are mixed. While the Ottawa Health Research Institute compiles a list of publicly available decision aids, other options require purchase.