Research articles to provide background reading for Shared Decision Making: 

British Medical Journal

Why do clinicians not refer patients to online decision support tools?

Interviews with front line clinics in the NHS.

This research paper published in the BMJ is by, amongst others,  Glyn Elwyn and Andrew Rix. Some colleagues will remember Glyn and Andrew from the Prepare to Share team that provided a thought provoking event in Newbury earlier this year. It was from this that many were encouraged to engage in SDM work in their local area.

This paper provides food for thought as it concludes ‘Health professionals were not motivated to refer patients to these interventions. Clinicians will not use these interventions simply because they are made available, despite good evidence of benefit to patients. These attitudes are deep seated and will not be modified by solely developing web-based interventions: a broader strategy will be required to embed DESIs into routine practice.’

Results showed-‘Fewer than expected patients were directed to use the web tools. The most significant obstacles to referral to the tools were the attitudes of clinicians and clinical teams. Technical problems contributed to the problems but the low uptake was mainly explained by clinicians’ limited understanding of how patient DESIs could be helpful in clinical pathways, their perception that ‘shared decision-making’ was already commonplace and that, in their view, some patients are resistant to being involved in treatment decisions.’

The full text can be found here:- BMJ Article

The findings of the research challenge how change in clinician behaviour is achieved. Comments/views and ideas from your experience welcomed. Please send to:


Implementing shared decision making in the NHS (Article: BMJ 2010;341:c5146 )


Lessons from patients’ journeys: Report in the BMJ

BMJ 2013;346:f1988 (Published 3 April 2013)
Peter Lapsley, patient editor, BMJ

Peter Lapsley, patient editor at the BMJ, reflects on the lessons that have emerged from the first 100 articles in the Patient’s Journey series

“Over the past seven or eight years, I have been helping patients to get their stories published, obtaining doctors’ perspectives on them, and, with colleagues, developing the guidelines for drafting patients’ journeys, hoping that these might increase the usefulness of such articles to doctors (box).”

Full article is available here:-


The King’s Fund

Making Shared Decision Making a reality: no decision about me without me: Angela Coulter; Alf Collins


The Cochrane Collaboration

Stacey D, Bennett CL, Barry MJ, Col NF, Eden KB, Holmes-Rovner M, Llewellyn-Thomas H, Lyddiatt A, Légaré F, Thomson R. Decision aids for people facing health treatment or screening decisions. Cochrane Database of Systematic Reviews 2011, Issue 10. Art. No.: CD001431. DOI: 10.1002/14651858.CD001431.pub3

Légaré F, Ratté S, Stacey D, Kryworuchko J, Gravel K, Graham ID, Turcotte S. Interventions for improving the adoption of shared decision making by healthcare professionals. Cochrane Database of Systematic Reviews 2010, Issue 5. Art. No.: CD006732. DOI: 10.1002/14651858.CD006732.pub2


The New England Journal of Medicine

A recent perspective from the United States:-

Shared Decision Making – The Pinnacle of Patient Centered Care


Shared Decision Making to Improve Care and Reduce Costs: Report in the NEJM

Emily Oshima Lee, M.A., and Ezekiel J. Emanuel, M.D., Ph.D.

N Engl J Med 2013; 368:6-8January 3, 2013DOI: 10.1056/NEJMp1209500

NEJM perspective on why more rapid progress on shared decision making in healthcare is needed.

Studies also illustrate the potential for wider adoption of shared decision making to reduce costs. Consistently, as many as 20{79f878acaa41f375dcd804cc8c058b5459a5482f20a3b9f87269b26c8734749b} of patients who participate in shared decision making choose less invasive surgical options and more conservative treatment than do patients who do not use decision aids” p7


RightCare – Shared Decision Making

Information and materials including National Clinical Lead for SDM Steve Laitner

Information on leading research on SDM:-

Shared decision-making – A Reading List produced by QIPP Right Care

An Audience with Dr Steven Laitner, Lead for Shared Decision Making, February 2012. To listen to this event go to:-

The following documents accompany the event and are available to download:-

Measuring Shared Decision Making – A review of research evidence

This is a report for the Shared Decision Making programme, In partnership with Capita Group Plc.

There is a wealth of research evidence around Shared Decision Making: its purpose, the need for it and evidence of its benefits and challenges.  This report aims to complement existing literature and evidence, by focusing on measurement and evidence of implementation in England to date. In doing so, our objective is to support those with an interest in developing Shared Decision Making within their organisations, to help them to understand:

• What elements of the decision making process should be measured, including for example, decision readiness and decision quality
• What measures exist and what research evidence supports their use
• What evidence is there of the implementation of  these measures, and in what contexts?
This report provides a summary of the types of  measures that are available, a recommendation of which measures might be appropriate for the national programme as well as a rationale for the suggested approach.

Your Health – Your Decision

Evaluation and Output Report of the AQuA Workstream within the National Shared Decision Making Programme is now available.

“AQuA was delighted to win part of the Department of Health QIPP Right Care National tender for Shared
Decision Making in the crucial area of culture change. The programme has been very successful in delivering
culture change, patient empowerment and tools to measure Shared Decision Making in everyday clinical
practice, in a range of settings and clinical pathways.”

This report tells the story of AQuA’s work over the past year 2012/2013.


NHS Confederation

An uneasy consensus: patients, citizens and the NHS. Paper for event on 20-22 June 2012


The Health Foundation

Information on leading research on SDM

Helping people share decision making: A review of evidence considering whether shared decision making is worthwhile. (June 2012).

The MAGIC programme: evaluation
The Health Foundation’s MAGIC (Making good decisions in collaboration)programme aims to support clinical teams in primary and secondary care to embed shared decision making with patients in their everyday practice. This independent evaluation by the Office for Public Management (OPM) covers the first phase of the programme.
Published: April 2013
MAGIC evaluation.gif

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