Minority patient preferences, barriers, and facilitators for shared decision-making with health care providers in the USA: A systematic review

Monica Perez Jolles; Jennifer Richmond; Kathleen C Thomas

doi:10.1016/j.pec.2019.02.003

Minority patient preferences, barriers, and facilitators for shared decision-making with health care providers in the USA: A systematic review

Patient Educ Couns. 2019 Jul;102(7):1251-1262. doi: 10.1016/j.pec.2019.02.003. Epub 2019 Feb 10.

Authors

Monica Perez Jolles¹, Jennifer Richmond², Kathleen C Thomas³

Affiliations

¹ The Gehr Family Center for Health Systems Science, Keck School of Medicine, University of Southern California, Los Angeles, USA. Electronic address: mjolles@usc.edu.
² University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of Health Behavior, 135 Dauer Drive, 302 Rosenau Hall, CB #7440, Chapel Hill, NC 27599-7440, USA; American Institutes for Research, Research and Evaluation, 100 Europa Drive, Suite 315, Chapel Hill, NC 27517, USA. Electronic address: Jennifer_Richmond@unc.edu.
³ Division of Pharmaceutical Outcomes and Policy UNC Eshelman School of Pharmacy, UNC Health Sciences at MAHEC, University of North Carolina at Chapel Hill, 121 Hendersonville Road, Asheville, NC, 28803, USA. Electronic address: kathleen_thomas@unc.edu.

PMID: 30777613
DOI: 10.1016/j.pec.2019.02.003

Abstract

Objectives: This systematic review of contemporary literature sought to better understand racial and ethnic minority patients' shared decision-making (SDM) preferences, challenges and facilitators.

Methods: Data sources were PubMed, CINAHL, Embase, Google Scholar, PsycINFO, Sociological Abstracts, and Web of Science databases for publications between 2011 and 2016. Publications were included if they studied SDM during the clinical encounter for minority adults in clinical care in the United States. We conducted a narrative, descriptive synthesis of each study.

Results: From over 5000 publications identified through the search strategy, 18 met eligibility criteria following an abstract and full text (n = 685) review in Covidence. Studies focused on SDM in developing treatment plans (n = 10), and were conducted in primary care (n = 6) or hospital/health system settings (n = 6). Patients' decision preferences ranged from physician-driven altogether or initially, to patient-driven style. A comprehensive list of SDM facilitators and barriers was developed.

Conclusion: Despite strong policy and research SDM support to increase patient communication and a growing published literature, results suggest lack of representation of minority populations in contemporary literature.

Practice implications: Provider training may be needed to facilitate patient-provider transition from a passive toward a more active SDM engagement over time while confidence, trust and rapport is established.

Keywords: Communication models; Health disparities; Literature review; Minority patients; Patient-centered care; Race and ethnicity; Shared decision-making.

Publication types

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

MeSH terms

Decision Making, Shared*
Humans
Minority Groups*
Patient Preference*
Professional-Patient Relations*
United States