Shared Decision-Making Tools Show Promise for Minority Patients

.Salient findings based on a FAIR Health initiative give a glimpse into the value and utility of shared decision-making tools to patients of color.

By large, shared decision-making is seen as an essential patient engagement strategy that has proven to increase patient satisfaction, reduce healthcare costs and improve treatment outcomes.

Past studies have shown that when patients must make difficult medical choices, patient decision-making tools can enhance patient literacy for informed consent conversations.

The practice relies on vital patient education, patient-provider communication, and a joint decision between patient and clinician about a healthcare treatment.

However, shared decision-making discussions with providers do not happen as frequently for patients of color compared to White patients, FAIR Health researchers stated.

The initiative, funded by the New York Health Foundation, sought to advance shared decision-making among patients of color through decision aids concerning conditions that disproportionately affect minority populations, including uterine fibroids, slow-growing prostate cancer, and type 2 diabetes.

The tools provided educational material and cost information about the condition through decision aids, commonly used to facilitate shared decision-making.

“Patients, especially people of color, have often been marginalized rather than placed at the center of the healthcare system,” David Sandman, president of NYHealth, stated in the press release. “FAIR Health's decision aids are a step toward a more equitable healthcare system by equipping patients of color with the clinical and cost information they need to make informed decisions with their healthcare providers."

Following the four phases 18-month initiative, researchers noted three key themes.

Qualitative feedback from patients and providers showed that both groups had a positive perception of tools, finding as easy to use and helpful in providing cost information for shared decision-making discussions.

In the FAIR Health Consumer's shared decision-making survey, 80 percent of participants stated that the tools made decision-making "easier" or "much easier.” Additionally, 76 percent noted that the cost information was "helpful" or "very helpful,” and another 76 percent said they would recommend the tools to others.

Findings from the FAIR Health brief also indicated that ancillary educational content and resources, including checklists and links, can expand shared decision-making discussion.

When evaluating what sections of the shared decision-making website were the most useful, 57 percent of respondents stated the checklist and toolkits. Similarly, 55 percent of respondents stated that the resources were helpful.

 “I really liked the shared decision-making checklist,” a participant stated, according to the Fair Health brief. “I thought it was very helpful. It gave you a lot of exploratory questions to prepare, like before, during and after the appointment, that wouldn’t have really crossed my mind.”

Overall, the initiative results show an appetite for this type of discussion among patients and providers. 

"The project findings show that there is a need for shared decision-making tools and educational content like those offered by FAIR Health through this initiative,” said Chima Ndumele, MD, project collaborator. “Shared decision-making is one important strategy, among many, to facilitate equitable access to and use of healthcare."

Although this patient engagement strategy may appear intuitive, shared decision-making tools are limited across the healthcare industry.

Limitations such as time constraints, limited reimbursement structure, and few tools to facilitate shared decision-making have kept providers from adopting the strategy in any meaningful way.