Shared medical decision making - 02/04/25

Doi : 10.1016/j.jviscsurg.2025.03.004

Charles Sabbagh ^a,^b,⁎ , Quentin Denost ^c, Denis Blazquez ^b, Constantin Zaranis ^b, Muriel Mathonnet ^b,^d, Claude Rambaud ^e, Chloé Carrière ^b, Alain Deleuze ^b, Jean-Michel Fabre ^b,^f
for the
Federation of Visceral, Digestive Surgery (FCVD)
^a Department of Visceral and Digestive Surgery, CHU Amiens-Picardie, Rond Point du Pr-Cabrol, 80054 Amiens, France
^b Office of the Federation of Visceral and Digestive Surgery, 12, rue Bayard, 31000 Toulouse, France
^c Bordeaux Colorectal Institute, 220, rue Mandron, 33300 Bordeaux, France
^d Digestive, Endocrine and General Surgery Department, CHU de Limoges, 2, avenue Martin-Luther-King, 87000 Limoges, France
^e France Assos Santé, 10, Vla Bosquet, 75007 Paris, France
^f Department of Oncological and Minimally Invasive Surgery, CHU de Montpellier, 80, avenue Augustin-Fliche, 34090 Montpellier, France

^⁎Corresponding author at: Digestive, Endocrine and General Surgery Department, CHU Amiens-Picardie, Rond Point du Pr-Cabrol, 80054 Amiens cedex 01, France.Digestive, Endocrine and General Surgery Department, CHU Amiens-PicardieRond Point du Pr-CabrolAmiens cedex 0180054France

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Wednesday 02 April 2025

Highlights

•	Patient related outcomes measurement (PROMS) targets patient-reported outcomes of care.
•	Patient related experience measurement (PREMS) measures the patient's experience of care.
•	PROMS and PREMS are the cornerstone for assessment of the concept of patient-centered care.
•	Shared medical decision-making (SMD) increases patient satisfaction, which in turn improves treatment adherence.
•	SMD includes a discussion component and a decision-making component.
•	A meta-analysis estimated that SMD lengthened the average preoperative consultation by 1.5minutes.
•	SMD can be applied to emergency surgery.

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Summary

Involving the patient in medical decision-making is called shared medical decision-making (SMD). While the concept of SMD is nothing new, implementation has been slow to develop within current clinical practice, although there is growing interest in this topic in the scientific literature. SMD requires full agreement with the patient, who becomes an actor in their own care, and whose goals sometimes differ from those of the doctor. In a systematic review, it was reported that 75% of surgeons were in favor of SMD, while only 54% of patients favored it. The tools that support SMD can be extremely variable; they are not merely a document of information but must offer guidance to help the patients clarify their choices. They must allow for quality time for discussion, even though the time spent on SMD is perceived as a hindrance to its widespread adoption. The objectives of this work are to specify the essential steps in setting up SMD, and the assessment tools and applications for SMD in digestive surgery.

Le texte complet de cet article est disponible en PDF.

Keywords : Shared medical decision, Surgery, Treatment