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Z Evid Fortbild Qual Gesundhwes. 2017 Jun;123-124:23-27. doi: 10.1016/j.zefq.2017.05.020. Epub 2017 May 20.

Milestones, barriers and beacons: Shared decision making in Canada inches ahead.

Author information

1
Research Centre of the Centre Hospitalier Universitaire de Québec, Quebec, QC, Canada; Department of Family Medicine and Emergency Medicine, Université Laval, Quebec, QC, Canada; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Université Laval Research Institute for Primary Care and Health Services (CERSSPL-UL), Quebec, QC, Canada. Electronic address: France.Legare@fmed.ulaval.ca.
2
Faculty of Health Sciences University of Ottawa, Ottawa, Ontario, Canada; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
3
School of Public Policy, University of Calgary, Calgary, Alberta, Canada.
4
Centre for Action in Work Disability Prevention and Rehabilitation affiliated with Hôpital Charles LeMoyne Research Center, Rehabilitation Department, Université de Sherbrooke, Longueuil, Longueuil, QC, Canada.
5
Research Centre of the Centre Hospitalier Universitaire de Québec, Quebec, QC, Canada; Department of Family Medicine and Emergency Medicine, Université Laval, Quebec, QC, Canada; Centre intégré de santé et services sociaux de Chaudière-Appalaches, Hôtel-Dieu de Lévis, Lévis, QC, Canada; Department of Anesthesiology and Critical Care Medicine, Division of Critical Care Medicine, Université Laval, Quebec, QC, Canada.
6
Research Centre of the Centre Hospitalier Universitaire de Québec, Quebec, QC, Canada; Department of Family Medicine and Emergency Medicine, Université Laval, Quebec, QC, Canada; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Université Laval Research Institute for Primary Care and Health Services (CERSSPL-UL), Quebec, QC, Canada; Office of Education and Continuing Development, Faculty of Medicine, Université Laval, Quebec, QC, Canada.
7
Research Centre of the Centre Hospitalier Universitaire de Québec, Quebec, QC, Canada; Department of Family Medicine and Emergency Medicine, Université Laval, Quebec, QC, Canada; Université Laval Research Institute for Primary Care and Health Services (CERSSPL-UL), Quebec, QC, Canada.
8
Faculty of Health Sciences University of Ottawa, Ottawa, Ontario, Canada.
9
Research Centre of the Centre Hospitalier Universitaire de Québec, Quebec, QC, Canada; Department of Family Medicine and Emergency Medicine, Université Laval, Quebec, QC, Canada; Université Laval Research Institute for Primary Care and Health Services (CERSSPL-UL), Quebec, QC, Canada; Office of Education and Continuing Development, Faculty of Medicine, Université Laval, Quebec, QC, Canada.

Abstract

Canada's approach to shared decision making (SDM) remains as disparate as its healthcare system; a conglomerate of 14 public plans - ten provincial, three territorial and one federal. The healthcare research funding environment has been largely positive for SDM because there was funding for knowledge translation research which also encompassed SDM. The funding climate currently places new emphasis on patient involvement in research and on patient empowerment in healthcare. SDM fields have expanded from primary care to elder care, paediatrics, emergency and critical care medicine, cardiology, nutrition, occupational therapy and workplace rehabilitation. Also, SDM has reached out to embrace other health-related decisions including about home care and social care and has been adapted to Aboriginal decision making needs. Canadian researchers have developed new interprofessional SDM models that are being used worldwide. Professional interest in SDM in Canada is not yet widespread, but there are provincial initiatives in Alberta, British Columbia, Ontario, Quebec and Saskatchewan. Decision aids are routinely used in some areas, for example for prostate cancer in Saskatchewan, and many others are available for online consultation. The Patient Decision Aids Research Group in Ottawa, Ontario maintains an international inventory of decision aids appraised with the International Patient Decision Aid Standards. The Canada Research Chair in SDM and Knowledge Translation in Quebec City maintains a website of SDM training programs available worldwide. These initiatives are positive, but the future of SDM in Canada depends on whether health policies, health professionals and the public culture fully embrace it.

KEYWORDS:

Canada; Gesundheits- und Sozialwesen; Implementierungswissenschaft; Kanada; Politikwissenschaft; Wissenstransfer; berufsübergreifend; health and social care; implementation science; interprofessional; knowledge translation; partizipative Entscheidungsfindung; political science; shared decision making

PMID:
28532628
DOI:
10.1016/j.zefq.2017.05.020
[Indexed for MEDLINE]

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