Shared Medical Decision Making in Patients with Osteoarthritis of the Hip and Knee

Kevin J. Bozic, MD, MBA1,2, Jeffrey Belkora, PhD2, Vanessa Chan, MPH 1,2, Jiwon Youm, BS, MS3,

Tianzan Zhou, BS5, John Dupaix, MD6, Angela Nava Bye, MA, ATC4, Clarence Braddock, III, MD, MPH, FACP8, Kate Chenok, MBA7, James Huddleston III, MD4

WHAT IS SHARED DECISION MAKING (SDM)?

In SDM process both physician and patient make necessary

contributions to the dialogue.

Physician providers expert clinical knowledge of conditions,

treatment options and associated risks, benefits + limitations of

evidence.

Patient contributes personal input of their tolerance for risk,

preferences for lifestyle, and guiding values.

Shared Decision Making (SDM)

•Incorporates patient preferences and values into decision making

•Useful for‘preference sensitive care’

• No clear‘best’treatment option

•Goal: improve decision quality, reduce unwarranted variation

SHARED DECISION MAKING TOOLS

• Decision aids (DVD/booklets)• Disease, treatment alternatives

• Communication aids (prompt sheets, health coaches)• Develop questions (Question listing)

• Questionnaires • Assess knowledge, health related values, preference, decision status

WHAT ARE THE POTENTIAL BENEFITS OF SHARED DECISION MAKING?

• More informed patients

• More satisfied patients

• Increased efficiency of office visits

• More appropriate utilization of resources

PATIENT REACTIONS TO SHARED DECISION MAKING:

•“Great to refresh memories and helpful for future doctors.”

•“Complete and detailed, very informative”

•“Decision and consultation service was fantastic. Made me feel so well-prepared. This is how medicine should work.”

•“Having the booklet info available online was terrific. This was exactly the material (statistics) I was looking for all over the web, but having a hard time finding in a consolidated format that made sense.”

•“The consultation with doctor was superb.”

•“Everything was very proactive."

1University of California, San Francisco, Department of Orthopaedic Surgery 2University of California, San Francisco, Philip R. Lee Institute for Health Policy Studies

3University of California, San Francisco, School of Medicine 4Stanford University, Department of Orthopaedic Surgery

5University of California, San Diego, School of Medicine 6University of Hawaii, Department of Orthopaedic Surgery

7Pacific Business Group on Health 8Stanford University, School of Medicine