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Shared Decision Making in Health CareAchieving evidence-based patient choice$
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Glyn Elwyn, Adrian Edwards, and Rachel Thompson

Print publication date: 2016

Print ISBN-13: 9780198723448

Published to Oxford Scholarship Online: September 2016

DOI: 10.1093/acprof:oso/9780198723448.001.0001

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Shared decision making interventions and health inequalities

Shared decision making interventions and health inequalities

Chapter:
(p.230) Chapter 35 Shared decision making interventions and health inequalities
Source:
Shared Decision Making in Health Care
Author(s):

Marie-Anne Durand

Robert J. Volk

Glyn Elwyn

Publisher:
Oxford University Press
DOI:10.1093/acprof:oso/9780198723448.003.0035

Although the positive impact of shared decision making (SDM) interventions has been widely demonstrated, it is unclear whether these tools benefit disadvantaged patients, and are not, on the contrary, likely to increase existing inequalities. Disadvantaged patients experience a heavier disease burden and poorer health outcomes than the rest of the population and yet, struggle to engage, understand, and access relevant information and services. Our systematic review suggests that SDM interventions have a moderate positive effect on disadvantaged groups across various outcomes. They may even be more beneficial to disadvantaged patients than more advantaged groups and may contribute to narrow health inequalities, provided interventions are adapted to underserved patients’ needs. However, given the small sample sizes, variable quality, and heterogeneity of included studies, these findings should be interpreted with caution and further research in this area is needed.

Keywords:   Shared decision making, decision support interventions, health inequalities, disadvantaged groups, systematic review

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