Shared decision making (SDM) is a method to make the medical field more patient-centered. Shared decision is where both the process where both the patients and the clinician work together to come up with a treatment option. The clinician provides the medical knowledge and the patient provides their preferences. This approach has been shown to improve medication knowledge, accurate expectations, and satisfaction. The main barrier to using this approach is time constraint therefore health professionals are looking to pharmacists to provide this service during medication therapy management (MTM) sessions. The purpose of the study in the article is to see if this idea is feasible and how the resolution to the identified drug therapy problems are reported back to the primary care physicians (PCP).
The study took place in the Medicine Clinic at Hennepin County Medical Center in Minneapolis. The intervention was centered around an electronic template to help the pharmacist incorporate SDM into their MTM consultation. At the end of the study all the patients and the pharmacists responded positively after the encounter. The patient felt they understood their medications more and are more likely to discuss management concerns with their PCP. The drug therapy problems that were identified during the consultation were reported back to the PCP in many ways. 25% were reported back by the patients themselves, 30% were reported by pharmacists, and the other 40% were reported back by the patients and the pharmacists together.
I think this study is innovative. It shows how people are trying to make the healthcare field more patient centered and how pharmacists can help make it happen. This study is the first of its kind, therefore there are still some areas that needs to be improved on. One is the number of participants in the study. The total number of patients involved was only 20 patients and these patients on average are on 19 different medications. Because of the small number of participants, the result might be biased. What other weaknesses or strengths can be found in this study?
Schafer Montag Katherine, Gionfriddo R. Michael, Boehm H. Deborah. Shared decision making and medication therapy management with the use of an interactive template. JAPHA. doi:10.1016/j.japh.2015.12.013. (published 18 Feb 2016).