Shared decision-making in advanced kidney disease: a scoping review

BMJ Open, vol. 12, pp. e055248

Abstract

OBJECTIVES: To provide a comprehensive overview of interventions that support shared decision-making (SDM) for treatment modality decisions in advanced kidney disease (AKD). To provide summarised information on their content, use and reported results. To provide an overview of interventions currently under development or investigation. DESIGN: The JBI methodology for scoping reviews was followed. This review conforms to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist. DATA SOURCES: MEDLINE, Embase, Web of Science, Cochrane Library, Emcare, PsycINFO, PROSPERO and Academic Search Premier for peer-reviewed literature. Other online databases (eg, clinicaltrials.gov, OpenGrey) for grey literature. ELIGIBILITY FOR INCLUSION: . Records had to be on the subject of SDM, or explicitly mention that the intervention reported on could be used to support SDM for treatment modality decisions in AKD. DATA EXTRACTION AND SYNTHESIS: Two reviewers independently screened and selected records for data extraction. Interventions were categorised as prognostic tools (PTs), educational programmes (EPs), patient decision aids (PtDAs) or multicomponent initiatives (MIs). Interventions were subsequently categorised based on the decisions they were developed to support. RESULTS: One hundred forty-five interventions were identified in a total of 158 included records: 52 PTs, 51 EPs, 29 PtDAs and 13 MIs. Sixteen (n=16, 11%) were novel interventions currently under investigation. Forty-six (n=46, 35.7%) were reported to have been implemented in clinical practice. Sixty-seven (n=67, 51.9%) were evaluated for their effects on outcomes in the intended users. CONCLUSION: There is no conclusive evidence on which intervention is the most efficacious in supporting SDM for treatment modality decisions in AKD. There is a lot of variation in selected outcomes, and the body of evidence is largely based on observational research. In addition, the effects of these interventions on SDM are under-reported.

Authors 6

1. Noel Engels corresponding Aachen Internal Medicine

   Leiden University Medical Center · Maasstad Ziekenhuis · Santeon (Netherlands)

   Affiliation as printed

   Department of Shared Decision-Making and Value-Based Health Care, Santeon, Utrecht, The Netherlands n.engels@santeon.nl

   Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands

   Internal Medicine, Maasstad Hospital, Rotterdam, the Netherlands

   Department of Shared Decision-Making and Value-Based Health Care, Santeon, Utrecht, The Netherlands

2. Gretchen N. de Graav

   Maasstad Ziekenhuis

   Affiliation as printed

   Internal Medicine, Maasstad Hospital, Rotterdam, the Netherlands

3. Paul Bastiaan van der Nat

   St. Antonius Ziekenhuis

   Affiliation as printed

   Department of Value-Based Health Care, Sint Antonius Hospital, Nieuwegein, The Netherlands

4. Marinus van den Dorpel

   Maasstad Ziekenhuis

   Affiliation as printed

   Internal Medicine, Maasstad Hospital, Rotterdam, the Netherlands

5. Anne Margarethe Stiggelbout Aachen Department of Biomedical Data Sciences

   Leiden University Medical Center

   Affiliation as printed

   Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands

6. Willem Jan W. Bos Aachen Internal Medicine

   Leiden University Medical Center · St. Antonius Ziekenhuis

   Affiliation as printed

   Department of Value-Based Health Care, Sint Antonius Hospital, Nieuwegein, The Netherlands

   Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands