Shared Decision Making in primary care: barriers and facilitators from the physician's and patient's perspective—a scoping review.

Introduction Health-related communication and Shared Decision Making (SDM) are crucial elements of patient-centered care. Multiple studies have showed that the decision-making process is often far from ideal, where an ideal process involves the patient being active, understanding their treatment options, and expressing preferences clearly, while the physician has sufficient time and willingness to share knowledge and involve the patient in the decision-making process. The aim of this review was to identify the key barriers and facilitators influencing the adoption of Shared Decision Making (SDM) approach from both the physician’s and patient’s perspectives in primary healthcare in relation to the 5-step model of SDM. Material and methods A scoping review of resources published within the last five years was conducted in June 2024 on the basis of PRISMA-ScR. Specific barriers hindering the adoption of SDM were identified, which can arise at any of the five steps. Results The most common barriers include: time constraints and physician’s workload, lack of SDM culture and tradition, paternalistic model of healthcare, patients’ passive attitude and belief they are unable to make decisions. SDM facilitators include: trust, use of educational materials by physicians, belief that SDM will lead to better treatment outcomes, and training in communication for physicians. Conclusions Despite the challenges to public health, action should be taken to overcome these barriers, given the well-established benefits of SDM, although this will require time and necessary adaptations.