Evidence Summary

What is an Evidence Summary?

Key messages from scientific research that's ready to be acted on

Got It, Hide this
  • Rating:

Interventions that target patients, healthcare providers, or both may increase shared decision-making, but patients do not consistently report benefits

Légaré F, Stacey D, Turcotte S, et al. Interventions for improving the adoption of shared decision making by healthcare professionals. Cochrane Database Syst Rev. 2014;9:CD006732.

Review question

How effective are interventions aimed at improving healthcare providers’ use of shared decision-making by targeting patients, professionals, or both?


Shared decision-making involves patients working with their healthcare providers, using the best available evidence and the patient’s preferences and values, to make decisions about the best healthcare actions. Interventions to increase shared decision-making may be aimed at healthcare providers, patients, or both.

How the review was done

The researchers did a systematic review, searching for studies available up to August 2012. They found 39 studies, including 38 randomized controlled trials.

The interventions targeted patients in 18 studies (4055 people), healthcare providers in 8 studies (more than 593 providers), and both in 13 studies (5474 patients and 571 providers).

A variety of interventions were studied, including use of educational meetings, educational materials, paper and internet-based decision aids, and audit and feedback directed toward patients and/or healthcare providers.

Outcomes were categorized as patient-reported measures (such as how much control a patient believes he or she has in decision-making or how satisfied a patient is) or observer-based measures (objective measures of how much healthcare providers involve patients in making decisions).

What the researchers found

Evidence was of low or very low quality.

Compared with usual care, most interventions that targeted patients, healthcare providers, or both patients and providers improved the likelihood of shared decision-making according to observers, but not consistently according to patients.

Compared with interventions that targeted patients only:

  • interventions that targeted healthcare providers only did not improve the likelihood of shared decision-making according to patients; and
  • interventions that targeted both patients and healthcare providers improved the likelihood of shared decision-making according to observers, but not according to patients.


The quality of evidence about interventions to improve shared decision-making is low. Interventions that target patients or healthcare providers or both can increase use of shared decision-making according to observers but not according to patients.

Interventions to increase shared decision-making*

Target of intervention

Target of comparator



Usual care

Small improvement in patient-reported measures (4 studies)

Healthcare providers

Usual care

Large improvement in observer-based measures (3 studies)

No improvement in patient-reported measures (1 study)



No improvement in patient-reported measures (2 study)

Patients and healthcare providers

Usual care

Large improvement in observer-based measures (2 studies)

No difference in patient-reported measures (3 studies)



Large improvement in observer-based measures (1 study)

No improvement in patient-reported measures (3 studies)

*Findings reported are based on continuous measures.

†Based on standard mean differences (SMD): small improvement = 0.2 to 0.49 SMD, medium improvement = 0.5 to 0.79, large improvement = 0.8 or more.


Randomized controlled trials
Studies where people are assigned to one of the treatments purely by chance.
Systematic review
A comprehensive evaluation of the available research evidence on a particular topic.

Related Evidence Summaries

Related Web Resources

  • Colorectal cancer test recommendations

    Health Link B.C.
    Colorectal testing every 1-2 years is recommended for people between ages 50 and 74. Your doctor may recommend screening before age 50 and more often if you have an increased risk of this type of cancer (eg. family history of colon cancer, polyps or Crohn's disease).
  • Which medications can relieve allergic rhinitis?

    Informed Health Online
    If you have allergic rhinitis, there are medications you can purchase as tablets, nose drops or sprays. These include: antihistamines, steroids, leukotriene receptor antagonists, chromones, and decongestants. Research shows these are all effective treatments.
  • Several non-invasive treatments work for neck pain

    Institute for Work & Health
    Educational videos, exercise, and neck mobilization were more beneficial for treating neck pain or whip lash than ultrasound or electrical stimulation. Laser therapy, exercise and massage or acupuncture may help with chronic pain. Hard or soft collars did not work.
DISCLAIMER These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

Register for free access to all Professional content

Want the latest in aging research? Sign up for our email alerts.

Support for the Portal is largely provided by the Labarge Optimal Aging Initiative. AGE-WELL is a contributing partner. Help us to continue to provide direct and easy access to evidence-based information on health and social conditions to help you stay healthy, active and engaged as you grow older. Donate Today.

© 2012 - 2020 McMaster University | 1280 Main Street West | Hamilton, Ontario L8S4L8 | +1 905-525-9140 | Terms Of Use