Shared decision making and its role in managing uncertainty and reducing low-value care.

BACKGROUND: Shared decision making (SDM) has benefits for patients, healthcare professionals and the healthcare system. Involving patients in decisions about their healthcare is a healthcare right. OBJECTIVE: The aim of this article is to explore when and how to use SDM in consultations, and to increase awareness of the role of simple tools to support SDM, particularly in consultations where uncertainty and low-value care options exist. DISCUSSION: Implementing SDM into primary care consultations with general practitioners, practice nurses and other team members does not need specific tools, although there are many that can be helpful to assist clinicians and do not increase the length of consultations. Encouraging patients to ask questions in consultations, particularly about options; discussing the benefits and harms of options including waiting and watching; and exploring patients' values and preferences are important steps in the process.