New Guide Aids Shared Decision-making on COVID-19

“Evidence shows a clear benefit to using shared decision-making with patients,” said Anne Schneider, D,O., FAAFP, a 2021-2022 AAFP Vaccine Science Fellow and one of the guide’s co-authors. “This conversation guide provides a valuable framework for initiating and implementing shared decision-making when discussing COVID-19 treatment options with our patients.”

The guide, funded under an unrestricted grant from Pfizer Inc., places heavy emphasis on the SHARE approach, in which clinicians

• Seek their patient’s participation in the decision-making process,
• Help their patient examine and review treatment options,
• Assess what their patient values and prefers,
• Reach a decision with their patient about the best available option, and
• Evaluate their patient’s decision by showing support.

The guide also discusses the benefits of shared decision-making, as well as ethical considerations and social determinants of health that should be part of the process.

Schneider, who also serves as a practicing family physician for Edward-Elmhurst Health in Naperville, Ill., and medical director of the Dyson Wellness Center at North Central College in Naperville, outlined the guide’s value in helping FPs navigate important discussions.

“The guide stresses the importance of approaching our conversation with patients in an open, respectful and nonjudgmental way,” Schneider said. “The guide encourages individualizing and personalizing the shared clinical decision-making process by taking into account each patient’s preferences and values. By acknowledging and addressing unique social determinants of health of our patients, many of which the guide lists, discussions on treatment options for COVID-19 for patients can be optimized.”

While the guide focuses on COVID-19, the SHARE approach can be applied to virtually any medical condition.

“I use the SHARE approach in practice on a regular basis, particularly when it comes to treating hypertension in situations where there is more than one medication option,” explained Schneider. “I find the ‘S’ in SHARE to be particularly important. Seeking patients’ participation in their care really allows them to see they can be active participants in their health. It can be so empowering for patients in that moment.

“I try to spend the largest portion of the SHARE approach on the ‘A,’ or assessing the patient’s values and preferences,” Schneider continued. “I find it helpful to keep in mind each patient’s social determinants of health during this time. It is important to be aware of each patient’s individual experience to be able to meet them where they are at.” 

Schneider said using the guide has resulted in positive feedback from patients.

“When I use shared decision-making and the SHARE approach, I frequently have patients tell me they feel ‘listened to’ and ‘heard,’” she said. “I often see the sense of empowerment and satisfaction on patients’ faces as they leave the room after a visit where I use shared decision-making and the SHARE approach.” 

The conversation guide is the latest of several planned COVID-19 resources. In September, the Academy published a clinical guidance document for treating COVID-19 in high-risk patients. Additional content on evidence-based interventions and techniques that stress the importance of early COVID-19 treatment, and updated information on COVID-19 complications associated with high-risk conditions, will be published in the coming months.