Shared Decision Making in health (Decisions Compartides) is a project of the Catalan Health Ministry of the Generalitat de Catalunya. Physicians and patients are involved in shared medical decisions. Both parties share information (evidence based information about treatment options, cons and pros, patient preferences and values) and an agreement is reached on the treatment to implement.

1. Moharra M1; Pons JMV; Bañeres J2; Fontcuberta JM2; Costa N3
1.Agency for Healthcare Quality and Assessment of Catalonia; 2. Fundació Avedis Donabedian; 3.Catalan
Patient Advisory Council
Shared Decision Making in Catalonia:
a new step forward in improving decision making process

2. 2
Shared Decision Making
 At least two participants: physicians and patients are involved
 Both parties share information
(evidence based information about treatment options, cons and pros,
patient preferences and values.)
 An agreement is reached on the treatment to implement

3. 3
Background
 Cultural change
(physician-patient relationship)
 Internet use and new ICT
(ensure quality of information)
 Patients’ right and patient autonomy
 Improving health literacy and numeracy

4. 4
Patient Decision Aids (DA)
 Provide information about the available options on diagnosis
(screening) or treatment, benefit/risk, uncertainty.
Background

5. 5
Main Decision Aid Developers
Organisation Country
Ottawa Hospital Research Institute (OHRI)
Patient Decision Aids
Canada
Informed Medical Decisions Foundation
Shared Decision Making Program
USA
Agency for Healthcare Research and Quality
Effective Healthcare Program
USA
Mayo Clinic
Shared Decision Making National Resource Center
USA
The Health Foundation
Person-centred care resource center
UK
Servicio Canario de Salud
Participa y decide sobre tu salud
Spain
Background

6. 6
 Development process criteria (reports readability levels,
reports update, acceptable to users)
 Content criteria (list of options, benefits/advantages,
compares probabilities)
 Effectiveness criteria (evidence that it helps people know
about different options…)
Background

7. 7
 Agency for Healthcare Quality and Assessment of Catalonia
 Catalan Patient Advisory Council
Collaboration:
• Patient and family associations
• Scientific Societies
Objective
7
• To provide patients with the best scientific evidence through
information (health condition, appropriate treatment options,
test on patients’ values) for discussing with their doctors
reasonable treatment and decision options.

8. 8
Results
8
• Treatment options
• Pros and cons of each
option
• Life style conditions
• Patient Preference test
• FAQ
Advanced Chronic
kidney disease
Surgery Radiation
BraquitherapyActive surveillance
Peritoneal dyalisis Hemodyalisis
Localized prostate cancer
Transplantation

9. 9
Discussion
9
•To improve communication between healthcare
professionals and patients
• To make patients less passive in decision making
process
•To reduce overuse
•To improve adherence to the treatment.
Patient Decision Aids may help...
Stacey D et al; Decision aids for people facing health treatment or screening decisions (Review) 2014 The
Cochrane Collaboration.

10. 10
Discussion
10
• Lack of knowledge about supporting patients
making health decisions
•Time constraints
•Lack of resources
•Training of healthcare professionals
Challenges for the future...

11. 11
Conclusions
11
 Both Decision Aids will help to ensure that patients start being
involved in the treatment decision making with their doctors and
this might have an impact in the future in decreasing overuse or
increasing patient empowerment and satisfaction.
 These DAs not only emphasize the availability of multiple
treatment options and the role of the patient in this process but
the added value is that they take into account patients’
preferences, values and opinions.

12. 12
Conclusions
12
 There are however still some challenges to cope with in the
future such as the evaluation of this new DAs and the main
barriers and facilitators to overcome for its successful
implementation in the decision making process.

13. 13
Next steps
Healthcare professionals
Scientific societies
Research groups
2015
• Breast cancer
• Carpal tunnel
• Knee replacement surgery
• Diabetes
• C-section
• Hip replacement surgery
• Decisions at the end of life
2016
13

14. 14
http://decisionscompartides.gencat.cat
14
Montse Moharra
Agency for Healthcare Quality and Assessment of Catalonia
mmoharra@gencat.cat
http://aquas.gencat.cat

15. 15
Shared Decision Making (Decisions Compartides)
is a project of the Catalan Health Ministry of the Generalitat de
Catalunya
More information at: http://decisionscompartides.gencat.cat
© About this presentation. 2015, Generalitat de Catalunya. Departament de Salut. Agència de
Qualitat i Avaluació Sanitàries de Catalunya (AQuAS)
The contents of this presentation are under a Creative Commons license for Attribution-
NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0)
The license can be accessed at: http://creativecommons.org/licenses/by-nc-sa/4.0/deed.en