PCORI Funds Studies on Shared Decision Making

March 20, 2019
Kaiser Permanente, UCLA expand efforts to study programs that involve patients in choosing treatment approach

Two projects designed to use shared decision making to disseminate and implement research findings and to study ways of building shared decision making into clinical care have received funding from the Patient-Centered Outcomes Research Institute (PCORI).

The newly approved shared decision-making awards, funded through PCORI’s Dissemination and Implementation initiative, are:

• $2.1 million for a Kaiser Permanente initiative to implement the use of a decision aid for use by primary care physicians and surgeons as well as their patients who are managing their obesity and who are eligible for and considering weight-loss surgery. The project would expand the use of the decision aid in two large health systems in Washington and Pennsylvania. The PCORnet Bariatric Study is the largest, multisite longitudinal study of bariatric surgery, involving over 46,000 adults and 544 adolescents. The team’s shared decision making (SDM) approach has four core components: (a) identification of eligible patients, (b) delivery of an evidence-based patient decision aid, (c) a conversation guided by the six steps of SDM, and (d) documentation of the SDM conversation in the electronic medical record. 

• $1.7 million for a UCLA project to implement a shared decision making approach for diabetes prevention within two health systems, UCLA Health and Intermountain Health. The project will focus on patients with obesity and higher blood sugars who are diagnosed with prediabetes. The PCORI study developed a risk prediction tool that classified patients into one of four risk quartiles and provided a tailored risk estimate for placebo, lifestyle change, and metformin for individual patients with prediabetes. The project team will integrate this new tailored risk model into an existing shared decision making (SDM) approach that has shown to be effective in a clinical trial and is currently in standard use at UCLA. 

“Shared decision making is a vital component of patient-centered care, and it’s also a channel building patient-centered evidence into an individual’s decision making about their treatment options,” said PCORI Executive Director Joe Selby, M.D., M.P.H., in a prepared statement. “PCORI is dedicated to supporting research that improves the process by which patients, working with their clinicians, choose a treatment approach that works best for them. ‘Works best for them’ means that the decision is based to the greatest extent possible on patient-specific information. That is the kind of evidence PCORI aims to produce. These new awards will help bring this evidence directly to patients, to support them in making choices with their clinicians about their care.”

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