Background. Despite widespread advocacy for shared decision making (SDM), the empirical evidence regarding its effectiveness to improve patient outcomes has not been systematically reviewed. The purpose of this study was to systematically review the empirical evidence linking patient outcomes and SDM, when the decision-making process has been explicitly measured, and to identify under what measurement perspectives SDM is associated with which types of patient outcomes (affective-cognitive, behavioral, and health). Data Sources. PubMed (through December 2012) and hand search of article bibliographies. Study Selection. Studies were included if they empirically 1) measured SDM in the context of a patient-clinician interaction and 2) evaluated the relationship between SDM and at least 1 patient outcome. Data Extraction. Study results were categorized by SDM measurement perspective (patient-reported, clinician-reported, or observer-rated) and outcome type (affective-cognitive, behavioral, or health). Data Synt...

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Where Is the Evidence? A Systematic Review of Shared Decision Making and Patient Outcomes

Family caregiving affects millions of Americans every day, in all walks of life. At least 17.7 million individuals in the United States are caregivers of an older adult with a health or functional limitation. The nation's family caregivers provide the lion's share of long-term care for our older adult population. They are also central to older adults' access to and receipt of health care and community-based social services. Yet the need to recognize and support caregivers is among the least appreciated challenges facing the aging U.S. population. Families Caring for an Aging America examines the prevalence and nature of family caregiving of older adults and the available evidence on the effectiveness of programs, supports, and other interventions designed to support family caregivers. This report also assesses and recommends policies to address the needs of family caregivers and to minimize the barriers that they encounter in trying to meet the needs of older adults.

Families Caring for an Aging America

For many patients, the time spent meeting with their physician—the clinical encounter—is the most opportune moment for them to become engaged in their own health through the process of shared decision making. In the United States shared decision making is being promoted for its potential to improve the health of populations and individual patients, while also helping control care costs. In this overview we describe the three essential elements of shared decision making: recognizing and acknowledging that a decision is required; knowing and understanding the best available evidence; and incorporating the patient’s values and preferences into the decision. To achieve the promise of shared decision making, more physicians need training in the approach, and more practices need to be reorganized around the principles of patient engagement. Additional research is also needed to identify the interventions that are most effective.

Shared Decision Making: Examining Key Elements And Barriers To Adoption Into Routine Clinical Practice

ACC/AATS/AHA/ASE/ASNC/SCAI/SCCT/STS 2017 Appropriate Use Criteria for Coronary Revascularization in Patients With Stable Ischemic Heart Disease

ACC/AATS/AHA/ASE/ASNC/SCAI/SCCT/STS 2017 Appropriate Use Criteria for Coronary Revascularization in Patients With Stable Ischemic Heart Disease: A Report of the American College of Cardiology Appropriate Use Criteria Task Force, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, and Society of Thoracic Surgeons

Patient preferences for shared decisions: A systematic review

Background Pharmacist-patient communication in community pharmacies has been studied for over 25 years with little effort to evaluate this research comprehensively. Objective The main objective of this review is to examine and summarize how researchers have conceptualized, defined, and measured pharmacist-patient communication across studies and identify gaps in the literature. Methods Articles were compiled from a search of (1) Medline, IPA, CINAHL, and PubMed databases using the keywords, "counseling", "patient communication", "patient counseling", "patient education", "patient consult ∗ ", and/or "pharmacists", (2) bibliographies of selected articles. The search generated 56 studies on community pharmacy, of which 39 studies met the inclusion criteria. Results Most studies (72%) have used the term patient counseling, although pharmacist-patient communication and patient education were also used. The definition of patient counseling varies across studies. Almost half of the studies (49%) conceptualized pharmacist-patient communication solely as a pharmacist information provision activity. A total of 16 studies (41%) also focused on pharmacists' interpersonal behavior in addition to the information provision activity of the pharmacist. In contrast, patient communication behavior and the exchange process between both parties has been understudied. A total of 16 studies (41%) used a retrospective design. All studies used a cross-sectional design, with varying modes of data collection such as mail surveys, telephone interviews, nonparticipant observation, and shopper studies. Taped encounters are rare. Summary/Implications This review revealed that most studies have focused on a one way communication of pharmacists to patients. A need for examining the patient-pharmacist dyad is apparent. Future research could explore a greater use of taped encounters to analyze the interactive communication process, affective components of communication such as collaborative problem solving, interpersonal relationship development, and the expertise that patients bring into the encounter.

Conceptualizing and measuring pharmacist-patient communication: a review of published studies

Objective. To determine pharmacy students’ attitudes and academic performance related to journal club during 2 advanced pharmacy practice experiences (APPEs).

Design. Fourth-year pharmacy students were required to complete 3 journal club assignments during drug information and internal medicine APPEs.

Assessment. A majority (91.3%) of the 105 students who responded to a 21-item survey instrument indicated that journal club assignments during the drug-information APPE were valuable to their understanding of research design and statistics. Students who completed the drug-information APPE before the internal medicine APPE scored higher on their understanding of the strengths and weaknesses and the clinical relevance of studies and had a higher learning slope (p = 0.01) than did students who completed the internal medicine APPE first.

Conclusion. Incorporating journal clubs into APPEs is an effective means of teaching literature-evaluation skills to pharmacy students.

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Journal Clubs during Advanced Pharmacy Practice Experiences to Teach Literature-Evaluation Skills

Objectives. To assess students' perspectives on including education about herbal supplements in the curriculum. Methods. A 17-item questionnaire was distributed during regularly scheduled classes to third-, fourth-, and fifth-year pharmacy students. Results. A majority of the students perceived their knowledge of herbal supplements was inadequate. Almost all (95%) students reported a need to learn more about herbal supplements, primarily from pharmacy courses and books. Attitudes towards safety and efficacy of herbal supplements varied. Almost half agreed that herbal supplements should only be sold in pharmacies. Providing information on herbal supplements was viewed as the pharmacist's responsibility. Conclusions. Students perceive their knowledge about herbal supplements to be inadequate and desire more information through didactic courses. While pharmacy associations should establish guidelines for herbal education in pharmacy curricula, pharmacy schools should work towards developing a structured appr...

Bupendra Shah

Papers

Patient preferences for shared decisions: A systematic review

Conceptualizing and measuring pharmacist-patient communication: a review of published studies

Journal Clubs during Advanced Pharmacy Practice Experiences to Teach Literature-Evaluation Skills

Pharmacy Student Perspectives on Classroom Education About Herbal Supplements

Achieving optimal influenza vaccination rates: a survey-based study of healthcare workers in an urban hospital.