Shared decision-making and the duration of medical consultations: A systematic review and meta-analysis

van Veenendaal, H (通讯作者),Erasmus Univ, Erasmus Sch Hlth Policy & Management, POB 1738, NL-3000 DR Rotterdam, Netherlands.
2023-2
Objective: 1) determine whether increased levels of Shared Decision-Making (SDM) affect consultation duration, 2) investigate the intervention characteristics involved.Methods: MEDLINE, EMBASE, CINAHL and Cochrane library were systematically searched for experimental and cross-sectional studies up to December 2021. A best-evidence synthesis was performed, and interventions characteristics that increased at least one SDM-outcome, were pooled and descriptively analyzed.Results: Sixty-three studies were selected: 28 randomized clinical trials, 8 quasi-experimental studies, and 27 cross-sectional studies. Overall, pooling of data was not possible due to substantial heterogeneity. No differences in consultation duration were found more often than increased or decreased durations. . Consultation times (minutes:seconds) were significantly increased only among interventions that: 1) targeted clinicians only (Mean Difference [MD] 1:30, 95% Confidence Interval [CI] 0:24-2:37); 2) were performed in primary care (MD 2:05, 95%CI 0:11-3:59; 3) used a group format (MD 2:25, 95%CI 0:45-4:05); 4) were not theory-based (MD 4:01, 95% CI 0:38-7:23).Conclusion: Applying SDM does not necessarily require longer consultation durations. Theory-based, multilevel implementation approaches possibly lower the risk of increasing consultation durations. Practice implications: The commonly heard concern that time hinders SDM implementation can be contradicted, but implementation demands multifaceted approaches and space for training and adapting work processes.
PATIENT EDUCATION AND COUNSELING
卷号:107
ISSN:0738-3991|收录类别:SCIE
语种
英语
来源机构
Erasmus University Rotterdam; University of Amsterdam; University of Amsterdam
被引频次(WOS)
0
被引频次(其他)
0
180天使用计数
3
2013以来使用计数
3
EISSN
1873-5134
出版年
2023-2
DOI
10.1016/j.pec.2022.11.003
关键词
Shared decision-making Consultation duration Systematic review Implementation Multilevel
WOS学科分类
Public, Environmental & Occupational Health Social Sciences, Interdisciplinary
学科领域
循证公共卫生 循证社会科学-综合