For the October 2019 Australia’s Health Panel survey, we asked our panellists about their experience with Shared Decision Making. The aim of our survey was to gain a snapshot of the current gap between the ideals of Shared Decision Making and the reality within the Australian healthcare context as part of a project for our “Safety & Quality in Healthcare Special Interest Group”.

Sixty six panellists participated to share their perspectives on Shared Decision Making. Women made up the majority of participating panellists (68%, n=45), while participants also skewed older than the general population: 15% (n=10) were aged under 45, 39% (n=26) were aged 46-64 and 42% (n=28) were 65 or older. Panellists were also mostly from major cities (65%, n=43), with a sizeable minority being from regional areas (23%, n=15) and a small number from remote or very remote areas (9%, n=6). Interestingly, there was a large variation in the number of times panellists had seen their GP in the prior 12 months (see Table 1).

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Table 1- Responses to question “How often have you visited your GP or other primary health care provider in the past 12 months?”
Table 1- Responses to question “How often have you visited your GP or other primary health care provider in the past 12 months?”
An overwhelming majority of panellists (97%, n=56) believed that it was important for shared decision making to be part of their healthcare. This is particularly pertinent as only 68% (n=45) agreed that health professionals viewed them as a unique individual and considered what mattered to them in the healthcare process. Similarly only 65% (n=39) agreed that health professionals understood their health goals and concerns. This suggests that there is both a strong social license and strong need for healthcare professionals to more actively engage in shared decision making practices when treating Australians.

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Table 2- Responses to question "My health professional understands my goals of care and concerns".
Table 2- Responses to question "My health professional understands my goals of care and concerns".
Only 52% (n=31) of panellists agreed that when they were receiving care the health professional explained the options available including different treatment options and associated costs, as well as potential benefits and harms of each, in a way they could understand. A minority (39%, n=23) agreed that health professionals provided them with information, such as fact sheets, and brochures, to support them in making decisions. This indicates that a barrier for effective shared decision making in Australian healthcare is that consumers may not feel they have enough information and understanding to contribute to the decision making process. Fortunately, a majority (82%, n=49) agreed that they were given the oppourtunity to ask questions and raise concerns with healthcare professionals, which may help counter this potential barrier.

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Table 3- Responses to question "My health professional explains the options available to me including different treatment options and associated costs, as well as potential benefits and harms of each, in a way I can understand".
Table 3- Responses to question "My health professional explains the options available to me including different treatment options and associated costs, as well as potential benefits and harms of each, in a way I can understand".
In regard to making decisions, only 60% (n=35) of panellists agreed that healthcare professionals gave them sufficient time to consider their options of care and discuss them with family members or carers. Additionally 73% (n=43) of panellists agreed that their healthcare professional respects their views and the decisions that make about their healthcare. This adds further support to the there being value in further integrating Shared Decision Making in Australian healthcare.

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Table 4- Responses to question “My health professional respects my views and any decision/s I make about my health care”.
Table 4- Responses to question “My health professional respects my views and any decision/s I make about my health care”.

Finally, at the end of the survey panellists were given the option to provide additional information via free text. Out of these responses the overall theme emerged that the use of shared decision making by health professionals in Australia was highly variable. Some panellists noted that their GP was very patient centred while specialists they had seen were not. Others noted the opposite with Specialists being very patient centred, but GPs not. People noted that they had had variable experiences with different doctors of the same speciality, with some being good and some being not so good.

It is clear that no one type of healthcare professional is particularly good or bad at using Shared Decision Making processes. Improving the decision making process and healthcare outcomes for consumers will require collaboration with a range of different healthcare providers as they all have both expertise and room to improve.

In conclusion, it is clear that consumers value the concept of Shared Decision Making and believe that it should be part of their healthcare. Currently there is a high degree of variability across Australia in regards to whether consumers believe health care professionals are effectively involving consumers in healthcare decisions, suggesting that more active use of Shared Decision Making in the healthcare context could improve consumer experiences.

The Consumers Health Forum of Australia would like to thank all panellists for kindly giving their time to participate in this survey. Any questions about this survey and its findings can be directed to info@chf.org.au.

Note- as each question in the survey was optional the number of responses for each question varied across the survey. This is why the ‘n’ for each set of answers may not add up to the same total number of responses for each question.

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