Shared decision making for the allergist

Ann Allergy Asthma Immunol. 2019 May;122(5):463-470. doi: 10.1016/j.anai.2018.08.019. Epub 2018 Sep 7.

Abstract

Objective: Shared decision making (SDM) is becoming more commonly appreciated and used in medical practice as a way to empower patients who are facing treatment preference-sensitive conditions, such as allergic rhinitis, atopic dermatitis, food allergy, and persistent asthma. The purpose of this review is to educate the allergy health care provider about how SDM works and provide practical advice and allergist-specific SDM resources.

Data sources: PubMed and online patient decision aid resources.

Study selections: Studies and reviews relevant to SDM and patient decision aids relevant to the allergy health care provider were selected for discussion.

Results: There are ethical, practical, economic, and psychological imperatives for the implementation of quality SDM, particularly for chronic diseases. Many benefits and barriers of SDM have been identified and models have been developed to encourage implementation of quality SDM. For the allergy health care provider, SDM for asthma has been shown to improve adherence, outcomes, and patient satisfaction with care. Patient decision aids are useful tools for SDM and have recently been developed for allergen immunotherapy, severe asthma, and atopic dermatitis.

Conclusion: Effective SDM has been shown to improve adherence and lead to better outcomes. SDM should be universally implemented as a key component of patient-centered health care. Allergy health care providers should work with their patients to reach treatment decisions that align with their values and preferences.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Allergists / education*
  • Asthma / immunology
  • Asthma / physiopathology
  • Asthma / therapy*
  • Attitude of Health Personnel
  • Chronic Disease
  • Clinical Decision-Making / methods*
  • Decision Making, Shared*
  • Dermatitis, Atopic / immunology
  • Dermatitis, Atopic / physiopathology
  • Dermatitis, Atopic / therapy*
  • Desensitization, Immunologic / methods
  • Humans
  • Patient Compliance / statistics & numerical data
  • Patient Participation / methods*
  • Patient Satisfaction / statistics & numerical data
  • Treatment Outcome