Patient-centered care is becoming increasingly important in healthcare, and within this framework, Shared Decision Making (SDM) is gaining attention as a process where patients and healthcare professionals jointly decide on the best treatment plan. At a webinar co-hosted with Ubie, we at 3Rock discussed the significance of SDM, the barriers to its implementation, and how it varies by disease area and patient journey. Based on this content, we would like to reintroduce the concept of SDM and the role pharma companies can play in support.

What is SDM?

SDM is an approach to deciding the most appropriate treatment plan. While the concept is surely appealing, it has not been around for long. Historically, healthcare communication was characterized by paternalism, where doctors directed and determined patient care in a one-sided manner. Since the 1990’s, the process of informed consent, where patients give consent after receiving explanations from doctors, became widespread. Eventually, the concept of SDM emerged, where patients, their families, and medical teams discuss and share information and preferences to choose the most appropriate treatment together.

Fostering communication with a focus on SDM is expected to improve patient satisfaction with treatment and encourage active participation in their care. For example, the Japanese Cancer Research Center is working on SDM by developing a decision support program in order to “help patients organize information in advance based on their values and preferences about post-standard cancer treatment and care, allowing them to discuss and share this with their families and healthcare providers, demonstrate scientifically the effectiveness of this program, and build a system to implement it in society.”

The Practice of SDM

As a concept, SDM may seem ideal. But how should SDM be implemented in practice? Questions arise, such as whether there are differences depending on the medical field or disease, what the ideal form of SDM might be, and how it fits into how medical communication is generally conducted. Interestingly, a meta-analysis on this subject has been conducted abroad. This studies compares SDM models and guidelines worldwide, and highlights that the “ideal form of SDM” differs depending on the disease.

For instance, in the oncology (cancer treatment) field, this is how some select elements are emphasized:

Here is a short further exposition of some of these terms:

Describe Treatment Options: Provide clear explanations of potential choices for the patient.
Tailor Information: Offering information specific to the patient’s unique situation.
Deliberate: Healthcare providers and patients jointly discuss the treatment plan.
Offer Time: Providing sufficient time for the patient to reflect and consider their decisions.

In contrast, in non-oncology fields, different communication elements, such as setting an agenda or building partnerships, are deemed more critical. From 3Rock’s experience, we see that even within the same disease state, the information and support needed by patients varies depending on where they are in their patient journey. Therefore, it is essential to pinpoint where these medical needs intersect. Personalized medical communication is required for an ideal outcome.

Approaches by Pharmaceutical and Medical Device Manufacturers

For companies to successfully engage with SDM, just adding a tag-on SDM support tool to their plans is unlikely to provide any impact. A sufficiently planned approach is essential. Designing patient personas and mapping the patient journey are effective as a first step. Once an overall strategy is built, SDM should be executed as part of that strategy. Falling into the trap of building an SDM program first, and then trying to wrap a strategy around that can also bring trouble. It’s crucial to conduct a situational analysis based on stakeholder needs and disease area trends first, and then identify where your company can best contribute.