IMPACT OF THE IMPLEMENTATION OF A SHARED DECISION-MAKING MODEL: RESULTS OF A PILOT STUDY IN PATIENTS WITH OBESITY
Background: Shared decision-making (SDM) is a process that promotes person-centered care. To our knowledge, few individual, heterogeneous studies have been published on the SDM in obesity, and none evaluate a holistic approach to obesity.
Objectives: We aimed to create a specific tool for the SDM in obesity and to evaluate the impact of the model in a tertiary care setting.
Methods: We performed a pilot randomised controlled trial, including adults living with obesity, attended at our Obesity Unit in April-June 2022. Patients were randomised 1:1 to standard-of-care versus SDM. SDM process included the creation of a specific tool. It consisted of a three-phases: team, options, and decision talk. The analysed variables were: Type of treatment chosen, degree of knowledge of therapeutic options, satisfaction with the decision, quality of the process, and decisional conflict scale.
Results: 25 patients/group were included, without statistically significant differences regarding baseline characteristics. The degree of knowledge of the treatment options and the degree of satisfaction with the decision was statistically higher in the SDM group (80.0 vs 48.8%, p<0.001; 93.5 vs 80, 6, p=0.003, respectively). Furthermore, the SDM group had a better perception of the quality of the decision-making process (48.3 vs 447; p=0.050) and a lower score on the decisional conflict scale, although this difference was not statistically significant (37.3 vs 43.1; p=0.217).
Conclusions: The proposed SDM model improves knowledge of the type of treatment for obesity, as well as the degree of satisfaction with the decision-making process. The results of this pilot reinforce the possibility of scaling the SDM model at the hospital level and implementation in daily clinical practice.
Patient, public and/or healthcare consumer involvement: Patients participated in the validation of the decision aid content.