Shared decision- making (SDM) is the bidirectional communication between a patient and healthcare professional (HPs) to reach an informed choice. Examples include decisions about screening and diagnostic tests, treatments, and future care (advance care planning). SDM recognizes that HPs and patients bring different but equally important forms of expertise to the decision-making process: HPs are disease experts (knowledgeable of causes and mechanisms, likely prognosis, tests and treatment) while patients (each with their own values, preferences, and goals of care) are illness experts. Based on the bioethical principle of patient autonomy, SDM augments the ethical requirement of informed consent. In addition, it contributes to enhance the patient-HP relationship, increase patient understanding, trust, and adherence to treatment plans. Despite these advantages, implementation of SDM in neurology can be particularly challenging, e.g. in the intensive care unit, or in patients with communication difficulties or reduced decisional capacity.
Our main goal is to assess the implementation of the SDM model in the different contexts and settings of neurology clinical care, and research. The presence of multiple treatment partially effective options in many chronic neurological diseases highlights the preference-sensitive nature of most decisions in neurology. Moreover, many neurological disorders are characterized by a variable degree of communication and cognitive compromise, which represent additional challenges to SDM practice, in both the clinical and research settings.
For this Research Topic We are interested in all the different components of SDM in neurology, and allied disciplines (e.g. rehabilitation, genetics, palliative medicine). Interventions include those targeting patient values clarification, risk communication, decision aids, and training programs for patients and HPs. Outcomes include patient and HP self-reported outcomes (e.g. risk knowledge, satisfaction with care, decisional conflict, self-confidence); treatment adherence/persistence; cost-effectiveness and process evaluation. Finally, the implementation of SDM in different countries and cultures is of upmost importance.
Areas of interest include, but are not limited to the following:
• Studies mapping the main barriers and facilitators to the implementation of SDM in neurology across the different neurological disorders, health care systems, and cultures
• Outcome measures to be used in descriptive and evaluative studies
• Interventions targeting HPs, patients, and both parties
• Studies that apply qualitative, quantitative, or mixed-methods approaches
We welcome translation and clinical articles including Original Research, Systematic Review, Methods, Review, Mini Review, Hypothesis and Theory, Perspective, Clinical Trial and Opinion.
C. Heesen received financial support from Biogen, Merck, Novartis and Roche. A. Solari received financial support from Almirall, Merck Serono, and Novartis.
Shared decision- making (SDM) is the bidirectional communication between a patient and healthcare professional (HPs) to reach an informed choice. Examples include decisions about screening and diagnostic tests, treatments, and future care (advance care planning). SDM recognizes that HPs and patients bring different but equally important forms of expertise to the decision-making process: HPs are disease experts (knowledgeable of causes and mechanisms, likely prognosis, tests and treatment) while patients (each with their own values, preferences, and goals of care) are illness experts. Based on the bioethical principle of patient autonomy, SDM augments the ethical requirement of informed consent. In addition, it contributes to enhance the patient-HP relationship, increase patient understanding, trust, and adherence to treatment plans. Despite these advantages, implementation of SDM in neurology can be particularly challenging, e.g. in the intensive care unit, or in patients with communication difficulties or reduced decisional capacity.
Our main goal is to assess the implementation of the SDM model in the different contexts and settings of neurology clinical care, and research. The presence of multiple treatment partially effective options in many chronic neurological diseases highlights the preference-sensitive nature of most decisions in neurology. Moreover, many neurological disorders are characterized by a variable degree of communication and cognitive compromise, which represent additional challenges to SDM practice, in both the clinical and research settings.
For this Research Topic We are interested in all the different components of SDM in neurology, and allied disciplines (e.g. rehabilitation, genetics, palliative medicine). Interventions include those targeting patient values clarification, risk communication, decision aids, and training programs for patients and HPs. Outcomes include patient and HP self-reported outcomes (e.g. risk knowledge, satisfaction with care, decisional conflict, self-confidence); treatment adherence/persistence; cost-effectiveness and process evaluation. Finally, the implementation of SDM in different countries and cultures is of upmost importance.
Areas of interest include, but are not limited to the following:
• Studies mapping the main barriers and facilitators to the implementation of SDM in neurology across the different neurological disorders, health care systems, and cultures
• Outcome measures to be used in descriptive and evaluative studies
• Interventions targeting HPs, patients, and both parties
• Studies that apply qualitative, quantitative, or mixed-methods approaches
We welcome translation and clinical articles including Original Research, Systematic Review, Methods, Review, Mini Review, Hypothesis and Theory, Perspective, Clinical Trial and Opinion.
C. Heesen received financial support from Biogen, Merck, Novartis and Roche. A. Solari received financial support from Almirall, Merck Serono, and Novartis.
